Neurologic aspects of temporal arteritis

IN THE YEARS 1931 to 1959, 175 patients with temporal arteritis were seen at the Mayo Clinic. At least 111 of these patients were referred to the Clinic with symptoms or signs suggesting possible involvement of the central nervous system, and 88 were seen primarily or in consultation by a neurologist at the Clinic. The referring physicians sent 41 patients because of headaches, 37 because of blindness, and 4 because of diplopia without any specific diagnosis. Brain tumor was suggested in 11, trigeminal neuralgia in 8, meningitis in 2, subarachnoid hemorrhage in 2, “stroke” in 2, histaminic cephalgia in 2, pituitary cyst in 1, and other diseases in 52 (Table 1) . Only 13 patients were referred with conditions already diagnosed specifically as temporal arteritis. Although temporal arteritis is seemingly rarely fatal, at least in the United States, it is often incapacitating. The importance of establishing the diagnosis rapidly can be appreciated when it is realized that 42% of the patients seen at the Clinic became blind in one or both eyes before diagnosis was made, even though loss of sight might have been prevented by early adequate steroid therapy.