To the Editor—
Although temporal arteritis (TA) has been well described, it is not widely appreciated that some cases are atypical. The condition may be unrecognized until irreversible damage has occurred. The article by Kansu et al1 documenting two cases of biopsy-proved TA with normal sedimentation rates emphasizes this aspect. The following case was observed by the author and further illustrates this point.
Report of a Case.—
A 73 year-old man was admitted for progressive facial pain and intermittent diplopia. One year before, he had experienced sudden, stabbing pains in the left cheek that radiated into the left temporal scalp. There were no trigger spots, but chewing movements precipitated the symptoms. Intermittent dizziness and double vision would often accompany the pain. Weight loss occurred due to fear of pain in chewing. Examination was unrevealing. Specifically, there were no areas of focal alopecia or atrophy; no nodularity or tenderness