Temporal arteritis presenting as ataxia and dementia

The case reported here illustrates some of the protean manifestations of temporal arteritis. Perhaps, as more cases with atypical manifestations are described, physicians will become more alert to the possibility of this diagnosis. It is now our policy to include temporal arteritis high on the list of differential diagnoses for any neuropsychiatric, visual, or systemic complaint in an elderly patient, even in the absence of typical manifestations. A temporal artery biopsy done relatively early in undiagnosed illness may reveal a very treatable cause. We wish to emphasize the need for early consideration of temporal arteritis in the elderly patient with an elevated ESR and any unexplained neuropsychiatric problem.