Transient ischaemic attack in a patient with known temporal arteritis: a case report

Area of Science:

• Rheumatology
• Neurology
• General Practice

Background:

• Giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) commonly affect older adults and are often managed in primary care with oral steroids.
• These inflammatory conditions are associated with an increased risk of other complications, including transient ischemic attacks (TIAs).
• The exact relationship between these conditions and their impact on clinical management in general practice remains unclear.

Observation:

• An 82-year-old woman presented with transient speech disturbance and disorientation.
• This episode occurred two weeks after discontinuing oral prednisolone for a biopsy-proven temporal arteritis (TA).
• Her medical history included ischemic heart disease but no other cardiovascular risk factors.

Findings:

• Transient ischemic attack (TIA) can be an alternative presentation or complication of inflammatory conditions like temporal arteritis (TA).
• This case highlights the importance of assessing comorbid risks in TA patients.
• Tailoring drug treatment, particularly steroid dosage and duration, is essential for preventing complications.

Implications:

• General practitioners must carefully manage steroid therapy in patients with TA to mitigate risks such as TIA.
• Further research is needed to establish precise management guidelines for TA and its associated complications.
• This case underscores the need for vigilance in diagnosing and managing TA, considering its potential neurological sequelae.