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Dysarthria associated with giant cell arteritis.

C C Lee1, W W Su, G G Hunder

  • 1Department of Rheumatology and Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA.

The Journal of Rheumatology
|May 6, 1999
PubMed
Summary

Giant cell arteritis (GCA) can cause painless dysarthria, a speech difficulty triggered by chewing or talking. This rare symptom, along with typical GCA features, resolved with treatment.

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Area of Science:

  • Neurology
  • Rheumatology
  • Ophthalmology

Background:

  • Giant cell arteritis (GCA) is a systemic vasculitis affecting large and medium arteries, primarily the aorta and its branches.
  • GCA commonly presents with headache, visual disturbances, scalp tenderness, and jaw claudication.
  • Cranial nerve involvement in GCA is well-documented, but specific speech articulation issues are rarely reported.

Observation:

  • A 74-year-old male presented with classic GCA symptoms including visual changes, headache, scalp tenderness, and elevated erythrocyte sedimentation rate.
  • The patient also experienced reproducible, painless dysarthria, characterized by difficulty speaking, particularly when chewing or talking for extended periods.
  • Symptomatic relief of dysarthria was achieved by resting the jaw.

Findings:

  • The patient's dysarthria, along with other GCA manifestations, significantly improved following appropriate GCA treatment.
  • This case represents the first documented instance of painless dysarthria as a presenting symptom of giant cell arteritis.
  • The findings suggest that GCA can manifest with subtle neurological symptoms affecting speech production.

Implications:

  • This case highlights the importance of considering GCA in the differential diagnosis of new-onset dysarthria, especially in older adults.
  • Early recognition and treatment of GCA are crucial to prevent irreversible complications such as vision loss.
  • Further research may elucidate the specific mechanisms by which GCA impacts speech articulation.

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