Temporal Arteritis Masquerading as Migraines

Abstract

We report on a 66-year-old patient referred to our clinic with sudden loss of vision in her right eye and decreased vision in the left, starting the day before admittance. She had suffered from migraines since early adulthood. Eight days earlier she had been referred to an ophthalmology clinic complaining of decreased vision in her right eye and was informed that she had occlusion of the arteries in the right eye. A complete ophthalmologic examination was performed. Her visual acuity was "no light perception" in the right eye and 20/32 (6/10) in the left. Her erythrocyte sedimentation rate was 51 mm/h and the C-reactive protein value was 9.5 mg/L. She was diagnosed as having temporal arteritis (TA) and was treated with high-dose pulsed intravenous corticosteroids. The final vision in the right eye was no light perception, and visual acuity was 20/25 (6/7.5) in the left. TA requires early diagnosis and treatment to prevent blindness. Sometimes, the diagnosis may be overlooked or delayed because of analgesic usage or another disease (e. g., migraine). Thus, a diagnosis of TA should be kept in mind for patients over 50 years of age presenting with sudden vision loss.