Address for treatment of superficial temporal arteritis

Dấu hiệu dễ nhận biết

Ông Lương Văn Thập (72 tuổi) ở xã Nam Sơn (Quỳ Hợp) nhập viện ngày 15/5 trong tình trạng đau nhức thái dương dai dẳng, cảm giác tê buốt như kim châm dưới da đầu.

Bệnh nhân nhập viện Bệnh viện Phục hồi chức năng Nghệ An. Ảnh: Sách Nguyễn

Tình trạng này kéo dài hơn 10 năm nay và hiện nay bệnh đã đau lan sang các bộ phận khác như: vùng trán, hốc mắt, đỉnh chẩm cùng bên. Do điều kiện kinh tế gia đình và chủ quan nên ông chưa điều trị mà chỉ uống thuốc nam. Chỉ đến khi đau quá không chịu được ông mới tìm đến Bệnh viện Phục hồi chức năng Nghệ An để điều trị.

GS - TS Nguyễn Văn Chương trực tiếp thăm khám cho bệnh nhân tại Bệnh viện Phục hồi chức năng Nghệ An. Ảnh: Sách Nguyễn

Tại đây, ông được GS. TS Nguyễn Văn Chương - Chủ tịch Hội Chống đau Hà Nội - người được Bệnh viện PHCN Nghệ An mời về trực tiếp hướng dẫn, chuyển giao khoa học kỹ thuật cho đội ngũ bác sỹ, y tá, điều dưỡng của bệnh viện thăm khám, lên phác đồ điều trị.

Sau 1 tuần điều trị tại bệnh viện, đồng thời thực hiện nghiêm ngặt theo chỉ dẫn của Giáo sư, bệnh của ông Thập đã tiến triển tốt.

Mr. Luong Van Thap said: With the treatment regimen combining injections, oral medication, physical therapy... now his pain has completely subsided, especially the restlessness at night has stopped, he sleeps better. His health has recovered very well.

Headache is the most prominent symptom of Horton's disease, typically pain in the temple area. Photo: Sach Nguyen

Talking with Prof. Dr. Nguyen Van Chuong, we learned that Horton's disease starts and progresses silently, without prominent symptoms. When symptoms appear, they usually manifest in the eyes in the following order: optic disc edema, pain in the eye socket, central retinal artery occlusion, double vision. In addition, the manifestations are accompanied by other symptoms such as: Pain in the temples due to superficial temporal arteritis. At that time, the patient experiences pain spontaneously, which can also be caused by stimuli such as pain when washing hair, combing hair, wearing tight hats, etc. The patient has persistent pain in the temples, a numbing sensation like needles pricking under the scalp.

Prof. Dr. Nguyen Van Chuong discusses how to recognize the symptoms of Horton's disease at Nghe An Rehabilitation Hospital. Photo: Nguyen Sach

In some cases, the pain spreads to other parts of the body such as the forehead, eye socket or occipital region on the same side. The pain increases when the weather is suddenly cold, the pain is severe at night causing the patient to lose sleep. Sometimes there are severe pains in the temporal region causing the patient to hold his head and scream. This acute pain lasts 2-3 hours, an average of 1-2 attacks/day causing the patient to be hospitalized. When the pain is acute, the patient's temporal region is swollen, the skin is red, hotter to the touch than other areas, and there is a feeling of a thick, hard blood vessel, weak or no pulse, and very painful when pressed. A common symptom is that the disease also causes inflammation of the arteries: face, behind the eyes, occipital causing ischemia in the chewing muscles, causing the patient to have a lot of pain when chewing, and the pain is reduced or gone when stopping chewing. In some cases, the patient also has a sore throat, tongue, swallowing, and difficulty speaking due to damage to the arteries that control there.

Dangerous complications

Horton's disease can cause a number of dangerous complications. Photo: Internet

Horton's disease causes eye complications that can appear suddenly, progress rapidly, and are irreversible, causing loss of vision within a few hours to a few days if not treated promptly. Common symptoms are photophobia, double vision, strabismus (due to paralysis of the ocular muscles), transient blindness, fog before the eyes, visual hallucinations, visual disturbances... and eventually complete blindness. Some patients have insomnia, loss of appetite, weight loss and fever, sometimes very high fever. Some other cases only have prolonged fever without other symptoms, fever of no known cause. In addition, many patients have symptoms of pseudo-polyarthritis of the extremities, the patient has pain in many joints, especially pain in the shoulder joints on both sides, but there is no limitation in joint movement, these signs of arthritis often appear before or are accompanied by headaches. In addition to the above symptoms, there are other rare symptoms that are easily confused with other diseases such as: cerebral infarction, neuritis, bronchial and pulmonary diseases; extracranial and intracranial arteritis, arteritis in the extremities; aortic aneurysm, aortic or coronary artery insufficiency... Temporal arteritis is easily overlooked in disease states such as: gradual generalized collapse; simple prolonged fever; intermittent claudication; angina or ischemic stroke in organs innervated by the major branches or trunk of the aorta.

Treatment

Professor, Dr. Nguyen Van Chuong said: Horton's is a disease that can be dangerous to vision, but if the patient is treated promptly and properly, this dangerous risk can be eliminated. Therefore, when there are suspicious signs, it is necessary to go to a medical facility for examination and specific advice.

To treat Horton's disease, corticosteroids are the only effective treatment. Photo: Sach Nguyen

At that time, to determine the disease, doctors will order some additional tests such as: increased blood sedimentation, blood clotting disorders, immune disorders and especially selective temporal artery biopsy based on Doppler ultrasound or external carotid angiography... This is an internal medical emergency and corticosteroids are the only effective treatment. The sooner corticosteroids are treated, the more eye complications can be avoided.

When having the above symptoms, the patient should immediately go to Nghe An Rehabilitation Hospital for timely examination and treatment. Photo: Sach Nguyen

To treat Horton's disease, corticosteroids (such as prednisone, solu-medrol) are the only effective treatment. The sooner corticosteroids are treated, the more eye complications can be avoided in the elderly. It can be said that when a physician suspects Horton's disease, there is no need to wait for the results of a temporal artery biopsy, but the patient should be treated with corticosteroids immediately.

This is a disease that can be dangerous to vision. Photo: Nguyen Sach

Corticosteroid therapy is the only effective treatment. The dangerous complications of Horton's disease can be avoided if treatment is started promptly, as an emergency when eye damage has already occurred. Corticosteroid therapy can restore vision only when vision is only partially lost, but complete loss of vision cannot be restored.

Science and Technology Council - Nghe An Rehabilitation Hospital

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