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Painful chewing and blindness: signs and symptoms of temporal arteritis
D T Allen1, M C Voytovich, J C Allen
1Department of Dentistry, Mayo Clinic, Rochester, Minn. 55905, USA. allen.david@mayo.edu
Background:
This case report illustrates the need to consider temporal arteritis in the differential diagnosis of jaw or tooth pain. This disease affects the cranial arteries, more frequently in women and usually in those older than age 60 years, causing jaw pain, visual symptoms, headache, scalp pain and sometimes blindness.
Case Description:
A 71-year-old man had jaw pain that increased with chewing and speaking, scalp tenderness and dimming vision. A temporal artery biopsy confirmed the diagnosis of temporal arteritis. Treatment with decreasing amounts of oral steroids over 23 months was successful in relieving his signs and symptoms and in saving his vision.
Clinical Implications:
Patients with this disease may seek care from their dentist first. Jaw or tooth pain is the most reliable clinical symptom in the diagnosis of temporal arteritis. Diagnosis and timely referral for treatment with oral steroids can prevent blindness.