Giant cell arteritis: symptoms, diagnosis and treatment

The NHS says the symptoms depend on which arteries are affected. The main ones are frequent, severe headaches, pain or tenderness at the side of the head (the temples) or on the scalp, jaw pain while eating or talking, and vision problems such as double vision or loss of vision in one or both eyes.

More general symptoms are also common, including flu-like symptoms, unintentional weight loss, depression and tiredness. Vasculitis UK adds fatigue, loss of appetite and fever, and describes pain in the tongue or jaw when eating (jaw claudication) as a classic symptom.

The NHS says to ask for an urgent GP appointment or get help from NHS 111 if you think you might have temporal arteritis, because it can lead to stroke and blindness if not treated quickly. Vasculitis UK explains that reduced blood supply to the brain can cause a stroke and reduced supply to the eyes can lead to blurred vision or, in some patients, blindness, and that damage to the eyes is usually the most serious complication.

The NHS cluster headache page lists jaw pain when eating, blurred or double vision, a sore scalp, or numbness or weakness in the limbs alongside a severe headache as possible temporal arteritis symptoms needing an urgent GP appointment or NHS 111. If you have problems with your vision you should have a same-day appointment with an ophthalmologist at a hospital eye department.

Vasculitis UK describes it as one of the commonest forms of vasculitis, inflammation of blood vessels. It affects one or two people per 10,000 in the UK, is more commonly seen in older patients and is seldom diagnosed below the age of 50. The cause is not yet known.

It is closely associated with polymyalgia rheumatica, which causes pain, stiffness and inflammation in the muscles around the shoulders, neck and hips. The NHS says some people with temporal arteritis also develop it, and Vasculitis UK notes the muscle weakness can be quite debilitating, typically affecting the upper arms and legs.

A GP will ask about your symptoms and examine your temples, and you will have blood tests before being referred to a specialist. The NHS says further tests may include an ultrasound scan of the temples or a biopsy under local anaesthetic, where a small piece of the temporal artery is removed and checked for signs of inflammation.

Vasculitis UK says there is no single test: the diagnosis is usually made because the doctor recognises the typical collection of symptoms and signs. Blood tests for inflammation such as ESR and CRP will usually be high but are not specific. A biopsy that shows inflammation helps to confirm the diagnosis, but one without inflammation does not exclude it.

The NHS says it is treated with steroid medicine, usually prednisolone, and that treatment will be started before the diagnosis is confirmed because of the risk of vision loss. There are two stages: an initial high dose for a few weeks to bring symptoms under control, then a lower dose given over a longer period, possibly several years. A small number of people need steroids for the rest of their life.

Do not suddenly stop taking steroids unless your doctor tells you to; stopping a prescribed course could make you very ill. Vasculitis UK says treatment is usually given for at least one or two years, with the dose reduced slowly, that there is a relapse rate of about 50 per cent, and that the prognosis is good with correct and early diagnosis and treatment.

You will have regular follow-ups to see how you are doing and to check for steroid side effects. Because steroids are taken for a long time, the NHS notes that other medicines may be added to protect the stomach and bones. Do not change the dose without advice.

On the NHS the pathway usually starts with an urgent GP or NHS 111 contact and a rapid specialist assessment, often with ultrasound or a biopsy. Treatment starts straight away. Private rheumatology and neurology clinics can offer assessment and scans, but the urgency of the condition means you should not wait for a private appointment if you have symptoms such as vision changes.