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September 1978

Giant Cell Arteritis With Normal Sedimentation Rate

Author Affiliations

Dept of Neurol Middlesbrough Gen Hosp Middlesbrough, Cleveland TS5 5A2 England

Arch Neurol. 1978;35(9):620. doi:10.1001/archneur.1978.00500330068023

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To the Editor.—  Kansu and colleagues (Arch Neurol 34:624-625, 1977) have written an interesting article on giant cell arteritis with normal sedimentation rate. Most neurologists will have seen similar cases but without the welcome biopsy confirmation offered by this report. I wish to illustrate a further point with reference to the onset of cranial arteritis during the concurrent suppression of another disorder with corticosteroids.

Report of a Case.—  A 69-year-old woman suffered intermittent left-sided headaches for many years, characteristic of migraine. For three years her late-onset asthma had been suppressed with prednisone, 10 mg daily. She had a 15-day history of poorly localized excruciating right-sided headaches and associated scalp tenderness. Three days before being seen, she noticed diplopia and blurred vision on the right. Examination disclosed a right sixth nerve palsy, a pale optic disk with paucity of retinal vessels on that side, and diminished visual acuity. Palpation of scalp

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