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Temporal Arteritis: Not to be Confused with Migraine

by Teri Robert, Lead Expert

Because headache can be a symptom of temporal arteritis, patients often think it's Migraine or another headache disorder. Temporal arteritis is sometimes called cranial arteritis or giant cell arteritis.

Temporal arteritis occurs when one or more arteries become inflamed and are damaged. It occurs most commonly in the head, especially in the temporal arteries that branch off the cartoid artery in the neck. The cause is unknown, but researchers think the inflammation is due to a faulty immune system response. It occurs almost exclusively in those over 50 years old, but may occasionally occur in younger people. There is some evidence that it can be hereditary.

Possible symptoms:

  • Excessive sweating
  • Fever
  • General ill feeling
  • Jaw pain, intermittent or when chewing
  • Loss of appetite
  • Muscle aches
  • Throbbing headache on one side of the head or the back of the head
  • Scalp sensitivity, tenderness when touching the scalp
  • Vision difficulties
    • Blurred vision
    • Double vision
    • Reduced vision (blindness in one or both eyes)
  • Weakness, excessive tiredness
  • Weight loss (more than 5% of total body weight)
  • Bleeding gums
  • Face pain
  • Hearing loss
  • Joint stiffness and / or pain
  • Mouth sores

When headache is a symptom, it's often throbbing and unilateral, which can cause people to think it's a Migraine. The visual symptoms can also be mistaken for a Migraine aura.

Diagnosis:

Diagnosis is begun with examination of the head, which may reveal sensitive scalp and a tender, thickened artery on one side. The artery may exhibit a weakened or absent pulse.

Blood tests may be ordered including:

  • hemoglobin or hematocrit, which may be low
  • liver function tests, which may be abnormal and show high levels of alkaline phosphatase
  • sedimentation rate
  • C-reactive protein

Blood tests are helpful in diagnosis, but blood tests alone do not confirm the diagnosis. In most cases a biopsy of the affected artery confirms the diagnosis.

Treatment:

The main goal of treatment of temporal arteritis is reducing tissue damage that can occur due to lack of blood flow. The most common treatment is corticosteroids such as cortisone, prednisone, and methylprednisolone. Aspirin is sometimes used. Occasionally, medications to suppress the immune system are prescribed.

Possible complications:

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