Disclaimer: This blog post is based on my experiences as a patient. I am on a long-haul journey to find answers and resolution to a chronic condition that I have suffered with for 11 years. I am not medically trained. While I have researched this subject matter carefully, this post does not provide medical advice. If you are suffering from symptoms that you think Temporal Arteritis may be the cause of, then please consult a medical professional.

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What Is Temporal Arteritis?

‘Temporal Arteritis (giant cell arteritis) is where the arteries, at the side of the head (the temples,) become inflamed and narrowed. It’s serious and needs urgent treatment.’ [1]Symptoms include a weak pulse, pain at the side of your head (temples,) tenderness on the scalp, and vision problems. Diagnostic tests for Temporal Arteritis are ultrasound of the temple and biopsy of the artery tissue. Corticosteroids are the ‘main modality of treatment, and have been shown to prevent blindness.’ [2]

Until 2020, I had periocular pain, around my upper eyelid and around my zygomatic arch. Four years ago, it developed into a pinching pain around my left temple, which now constantly pulsates. I have never experienced pain like it. I have not had my temple pain investigated, nor have I received any answers from ophthalmology about what this pain could be. This blog post asks if a part of my periocular pain, could involve Temporal Arteritis.

My Symptoms

My left temple throbs. The pain shoots all the way around the left side of my head, which gives me a head-ache. My temple is tender to touch, and my pulse is weak on the left side. I have very blurred vision in my left eye. It has been blurred since 2019, following my left superficial parotidectomy, but the blurriness has become more pronounced in the last nine months.

Diagnostic Tests

The blood tests, which doctors use to help diagnose Temporal Arteritis, are; Erythrocyte sedimentation rate, (ESR) and Plasma Viscosity. Both my ESR and Paslma Viscosity have been abnormal. Ultrasound scanning is a diagnostic modality, but according to Muhammed Ameer et al, ‘Temporal artery biopsy is the “gold-standard” diagnostic test for Giant Cell Arteritis, and must always be performed as early as possible.’ [3]I have not had a biopsy of my left temporal artery, nor any ultrasound scanning of my left temple.

The Superficial Temporal Artery

I have been learning about the superficial temporal artery, because I wonder whether it may be contributing to the pain around the left side my head and in my ear. The temporal artery supplies blood to your face and scalp. It has multiple branches that pass through the regions in my head and neck, where I experience pain. ‘The superficial temporal artery starts in your parotid gland and runs up and down between your cheekbone and your ear. It branches off into the frontal and parietal branches. Your frontal branch sends blood to your forehead’s muscles and skin. Your parietal branch provides blood to the temporal regions of your head. Other branches of the temporal artery include;

• Transverse facial
• Middle temporal
• Zygomatic-orbital
• Auricular [4]

Reflection

The emboldened words, in the paragraph above, are all the areas of my head and neck, where I am in pain. If my left temporal artery is inflamed, could the pain in my ear, around my zygomatic-orbital area, and around the left side of my head, be caused by an inflamed temporal artery?

It’s Not Adding Up

Something is not adding up between what ophthalmologists are saying, and the level of pain that I am experiencing. I have been to five ophthalmology clinics, at different NHS Trusts, in the UK. A professor of ophthalmology in London, diagnosed my left ptosis, in 2014. He told me that the left levitator on my eyelid had collapsed, and that it needs corrective surgery. But no ophthalmologist has explained what my periocular pain is. They say that there is nothing wrong, but this pain isn’t normal. I am most worried about the pain in my temple. The last ophthalmologist, who I saw a year ago, insisted that it is not Temporal Arteritis, but he refused to do any diagnostic testing, so without doing an ultrasound or a biopsy, how can he be so sure?

Ophthalmologists are excellent at saying what it isn’t, but they never say what it is. Giant Cell Arteritis ‘results from inflammatory changes in the vessel wall.’ [5] So, what else could my temporal pain be, when there has been suspected inflammation and infection in my periocular region for 11 years?

MRI Scans

In these radiology images, my left eye does not look healthy. There is visible swelling in the left temporal artery area. When I asked the ophthalmologist about this, he said that it is ‘just the angle plane of the image.’ That doesn’t resonate as true. Something is not adding up about what the ophthalmology world are not saying, and the amount of pain I am in.

Call to Action!

 

My temporal pain is severe. I have not had a fair hearing from the Ophthalmology world. The last ophthalmologist showed little interest in helping me. The same was true for the Ear Nose and Throat and the Oral Maxillofacial departments, at that NHS Trust. I have received similar indifference from the five other ophthalmology departments in the UK, who I have seen. I am getting a frosty and defensive vibe from my GP practice, who are keeping me at arm’s length. This is a vulnerable predicament to be in, and one that I have been in, for far too long.

The most feared complication of Giant Cell Arteritis is irreversible visual loss caused by ischemic optic neuropathy. Early treatment with corticosteroids can be vision saving.

Muhammed A et al

I do not want to end up with vision loss. This is an urgent call out for any ophthalmologists or oculoplastic surgeons, to please come forward. I will work patiently with you, for as long as it takes to remedy this. You can email me at info@myfacialpain.com, message me directly on my website, or message me on X, @myfacialpain.

Given the risk of irreversible visual loss, treatment with corticosteroids should not be delayed.

Muhammad A et al.

Foot Notes

[1] Temporal Arteritis, www. NHS.uk

[2] Muhammad AA, Peterfry R & Khazeni B; Giant Cell Arteritis (Temporal Arteritis) National Centre for Biotechnology Information, (NCBI.) Copyright © 2024 StatPearls Publishing, LLC

[3] Muhammad AA, Peterfry R & Khazeni B; Giant Cell Arteritis (Temporal Arteritis) National Centre for Biotechnology Information, (NCBI.) Copyright © 2024 StatPearls Publishing, LLC

[4] Superficial Temporary Artery, www.myclevelandclinic.org

[5] Same Author and source as footnote 2 & 3.

Photo Credits: CDD20, Jaron Nix on Unsplash, and Kalz on Pexels.