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Related Experiment Video

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An Immunohistopathologic Study to Profile the Folate Receptor Beta Macrophage and Vascular Immune Microenvironment in Giant Cell Arteritis

Published on: February 8, 2019

Giant Cell Arteritis Presenting With Multiple Cranial Neuropathies - Case Report.

Jessica J Ye¹, Marc A Bouffard², Earllondra Brooks³

¹Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.

The Neurohospitalist

|April 17, 2023

Summary

Giant cell arteritis (GCA) can rarely cause multiple cranial neuropathies, leading to symptoms like double vision. Temporal artery biopsy is crucial for diagnosing GCA in such cases.

Keywords:

case report giant cell arteritis multiple cranial neuropathies ocular motility disorders < cranial nerve diseases temporal artery biopsy

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Area of Science:

Ophthalmology
Neurology
Rheumatology

Background:

Giant cell arteritis (GCA) typically presents with vision loss, but can manifest with diplopia and cranial neuropathies.
An 84-year-old woman with a history of multiple cancers developed double vision, ptosis, and ophthalmoplegia.

Observation:

The patient presented with right eye mydriasis, ptosis, and ophthalmoplegia, indicative of cranial nerve III and VI neuropathy.
Initial workup for neoplastic, paraneoplastic, infectious, and inflammatory causes of multiple cranial neuropathies was negative.

Findings:

Elevated inflammatory markers and a subsequent temporal artery biopsy confirmed Giant Cell Arteritis.
Steroid treatment led to improvement in the patient's ophthalmoplegia and ptosis.

Implications:

This case highlights Giant Cell Arteritis as a rare but important cause of multiple cranial neuropathies.
Emphasizes the critical role of temporal artery biopsy in diagnosing GCA, even with atypical presentations.