Korean J Pain.  2007 Dec;20(2):255-257. 10.3344/kjp.2007.20.2.255.

A Case Report of Giant Cell Arteritis Combined with Oculomotor Nerve Palsy

• Ryu YB
• Han KR
• Kim C

• KMID: 2278077
• DOI: http://doi.org/10.3344/kjp.2007.20.2.255

Abstract

Giant cell arteritis, which is also referred to as temporal arteritis, is defined as a systemic vasculitis in individuals over 50 years of age. Here, we report a case of giant cell arteritis combined with oculomotor nerve palsy. An 81-year old female patient experienced a headache for 10 days in her left temporoparietal area, that was characterized by a continuous dull ache and heaviness with intermittent shooting and lancinating pain. Her symptoms persisted in spite of receiving strong analgesics in another hospital. Upon physical examination, she was found to have marked tenderness over the left temporal area, especially along the path of the temporal artery as well as limitation of adduction, supraduction and infraduction of the left eyeball. At the time of admission, her erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were 52 mm/hr and 3.94 mg/dl. In addition her brain MRI revealed no specific findings. Giant cell arteritis was suspected based on the clinical symptoms and signs as well as the elevated ESR and CRP. Oral steroid therapy started was started with an initial dose of 40 mg of prednisolone per day that was gradually tapered to 5 mg a day for 2 weeks. Her headache subsided one day after the steroid therapy and oculomotor nerve palsy was markedly improved after 2 weeks of the therapy. After 2 months she had recovered completely from her symptoms.

Keyword

giant cell arteritis; oculomotor nerve palsy; steroid therapy

MeSH Terms

Aged, 80 and over
Analgesics
Blood Sedimentation
Brain
C-Reactive Protein
Female
Giant Cell Arteritis*
Giant Cells*
Headache
Humans
Magnetic Resonance Imaging
Oculomotor Nerve Diseases*
Oculomotor Nerve*
Physical Examination
Prednisolone
Systemic Vasculitis
Temporal Arteries
Analgesics
C-Reactive Protein
Prednisolone