Temporal Arteritis Treatment
Temporal Arteritis treatment delays are a cause of litigation. The usual problem is that the diagnosis is not considered, so the correct tests are not done (Erythrocyte Sedimentation Rate - ESR and temporal artery biopsy). The most important treatment are corticosteroids, of which prednisolone (also called prednisone) is best. Prednisolone should be started at high doses e.g. 0.5mg to 1.0mg per kg of body weight. Most people would use about 40mg in an adult i.e 0.5mg/kg. Within days the headache will have resolved significantly and the patient will be feeling better. It is an old saying, and probably true, that someone who is not a lot better after a day or two of steroids does not have temporal arteritis (or polymyalgia rheumatica for that matter). If there is no response the diagnosis should be reviewed.
References
Unwin B and Gilliland W. Polymyalgia Rheumatica and Giant Cell Arteritis. American Family Physician 2006;74(9):1547-54. (Free Full Text)Salvarini C et al. Polymyalgia Rheumatica and Giant-Cell ArteritisNew England of Medicine 2002;347:261-71 (Free Abstract only)
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