The key difference between temporal arteritis and trigeminal neuralgia is that the temporal arteritis is a condition that occurs due to the inflammation of the temporal arteries, which supply blood to the head and brain. Whereas, the trigeminal neuralgia is a chronic pain disorder that affects the trigeminal nerve.
Thus, both temporal arteritis and trigeminal neuralgia are results of inflammatory conditions.
CONTENTS
1. Overview and Key Difference
2. What is Temporal Arteritis
3. What is Trigeminal Neuralgia
4. Side by Side Comparison – Temporal Arteritis vs Trigeminal Neuralgia in Tabular Form
5. Summary
What is Temporal Arteritis?
Temporal arteritis or giant cell arteritis is a disease that occurs due to the inflammation of the temporal arteries, which supply blood to the head and brain. This disease is almost always seen among patients who are over 50 years of age.
Clinical Features
- Headache
The patients will have headaches, mainly in the temporal and occipital regions. Arterial pulsation is lost, and it becomes hard and tortuous. Furthermore, touching the inflamed area in activities such as combing triggers pain.
- Facial Pain
The inflammation of the maxillary, facial, and lingual branches of the external carotid artery gives rise to a facial pain. This pain aggravates by the movements of the jaw. This is a characteristic symptom known as the jaw claudication. The patient finds it difficult to protrude the tongue and open the mouth.
- Visual Defects
The visual complications occur only in one-tenth of the reported cases. The occlusion of the posterior ciliary artery causes anterior ischemic optic neuropathy. There is a sudden unilateral loss of vision which is either partial or complete. Further, if the condition progresses, most often due to the failure of the patient seek immediate medical attention, central retinal artery occlusion can happen; in this case, the patient will get a sudden permanent unilateral loss of vision along with disc pallor.
Figure 01: Headache is a symptom of temporal arteritis
Diagnosis
ESR and liver enzyme levels rise in temporal arteritis. One should take biopsy samples from the temporal artery as soon as possible in order to confirm the diagnosis.
Management
The patient has to take high doses of steroids (usually prednisolone 1mg/kg/day) at least for one year.
What is Trigeminal Neuralgia?
The dilated vascular loop usually compresses the trigeminal nerve in the peripontine territory, and this gives rise to facial pain in the area of distribution of the trigeminal nerve. Young patients with trigeminal neuralgia, multiple sclerosis, or cerebellopontine angle face the risk of tumors.
Clinical Features
- The patient will experience episodes of electric shock-like or knife-like pain. And this pain usually begins in the mandibular region and lasts for several seconds; then, it gradually subsides only to recover after a refractory period of variable duration.
- Actions such as washing and shaving can also trigger the pain.
Management
Carbamazepine is the usual drug that relieves the pain. Lamotrigine and gabapentin are other options. The failure of the drugs to induce remission is an indication for the surgical interventions to relieve the compression of the trigeminal nerve. The recent advancement of the bioengineering technology has paved the way for the microvascular decompression of the pressure on the nerve.
What is the Difference Between Temporal Arteritis and Trigeminal Neuralgia?
Temporal Arteritis vs Trigeminal Neuralgia |
|
| Temporal arteritis or giant cell arteritis is a condition that occurs due to the inflammation of the temporal arteries, which supply blood to the head and brain. | Trigeminal neuralgia is the condition caused by the compression of the trigeminal nerve in the peripontine territory, giving rise to facial pain in the area of distribution of the trigeminal nerve. |
| Inflammation | |
| The inflammation happens in the temporal artery. | Trigeminal neuralgia is either due to the compression or inflammation of the trigeminal nerve. |
| Clinical Features | |
|
|
| Treatment | |
|
|
Summary – Temporal Arteritis vs Trigeminal Neuralgia
Temporal arteritis is a disease is a condition that occurs due to the inflammation of the temporal arteries, which supply blood to the head and brain. The key difference between temporal arteritis and trigeminal neuralgia is that, in temporal arteritis, the temporal artery is affected while, in trigeminal neuralgia, the trigeminal nerve is affected.
Reference:
1. Kumar, Parveen J., and Michael L. Clark. Kumar & Clark clinical medicine. Edinburgh: W.B. Saunders, 2009.
Image Courtesy:
1. “1557799” (CC0) via Pixabay
2. “Trigeminal Neuralgia” By BruceBlaus – Own work (CC BY-SA 4.0) via Commons Wikimedia
During my 70’s I was diagnosed with Temporal Arteritis several years ago in a hospital after innumerable tests. I was given prednisone, a large dose immediately in the hospital then a course of 16 days gradually reducing the dosage to nil. I have been ok until two weeks ago, I am now 82, I told the hospital about my Temporal Arteritis, they did a blood test and a CT scan and decided it was Trigeminal Neuralgia and are treating me with Carbamazapine. I am concerned because all the symptoms I had seemed to point to the recurrance of Temporal Arteritis as I had no facial pain, just the terrible pain in my temporal region as before.
As it was the weekend and Covid9 is at large I decided to wait until Monday to see my GP. He immediately sent me to the hospital for tests, and by this time the pain had receded considerably.
I have not had the pain since, but I am still concerned what effect the Carbamazapine may have, especially if I have been mis-diagnozed. What should I do? I was told to stay on the Carbamazapine for a month and to go back to my GP towards the end when if all is okay he will reduce the dosage until it is nil.