Neurológia pre prax 3/2011

Temporal arteritis – an acute condition reguiring emergency care

Temporal arteritis (TA) is an inflammatory vasculopathy of old people. Neurologic manifestations include headaches, memory disturbances, and dementia; from the ophthalmologic point of view, it is sudden and irreversible decrease or loss of visual functions. The systemic manifestations include fatigue, scalp tenderness, night swelling, loosing the weight, intermittent claudication during mastication or walking, and pain of the muscles. The early diagnosis is mandatory for the beginning of the treatment; its delay may be also the cause of blindness. Clinically, the diagnosis is based on high, and otherwise without other reasons, ESR, or CRP as well. Definitely, the diagnosis is confirmed by histopathological examination of the superficial temporal artery biopsy specimen. The cornerstone of the treatment is the corticosteroid therapy. The activity of the disease is monitored by means of the ESR values. It is necessary to follow-up the patients until the end of their life and the chronic corticotherapy is very often lifelong necessity. Ill-considered withdrawn from steroids, may have fatal consequences for the patient.

Keywords: temporal arteritis, giant-cell arteritis, Horton’s disease, ESR, corticotherapy, sudden blindness.