Skip to main content

Horton’s disease: Past and present

Current Pain and Headache Reports volume 9, pages 259–263 (2005)Cite this article

Abstract

Although the disease known as temporal arteritis, giant cell arteritis, and Horton’s disease has been known since at least the 10th century, Hutchinson (1890) and Horton (1932) characterized the condition in the more recent medical literature. The diagnosis of this potentially serious illness can be surprisingly elusive, and treatment is fraught with some frustrating pitfalls. For the most part, careful evaluation of patients (usually elderly) with the typical presentation of head pain and constitutional signs yields prompt diagnosis. Treatment with corticosteroids, the standard since the mid-1950s, is usually very successful in relieving pain and tenderness and in preventing visual and other sequelae. This article discusses the evolution of medical understanding of the disease, pathophysiology, diagnosis, and modern treatment options.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

References and Recommended Reading

  1. Horton BT, Magath TB, Brown GE: An undescribed form of arteritis of temporal vessels. Mayo Clin Proc 1932, 7:700–701.

    Google Scholar 

  2. Meadows SP: Temporal or giant cell arteritis. Proc Royal Soc Med 1966, 59:329–333.

    CAS  Google Scholar 

  3. Ainsworth RW, Gresham GA, Balmforth GV: Pathological changes in temporal arteries removed from unselected cadavers. J Clin Pathol 1961, 14:115–119.

    PubMed  CAS  Google Scholar 

  4. Paulley JW, Hughes JP: Giant cell arteritis or arteritis of the aged. BMJ 1960, 2:1562–1567.

    PubMed  CAS  Google Scholar 

  5. Hutchinson J: On a peculiar form of thrombotic arteritis of the aged which is sometimes productive of gangrene. Arch Surg 1890, 1:323–329.

    Google Scholar 

  6. Jennings GH: Arteritis of the temporal arteries. Lancet 1938, 1:424–428.

    Article  Google Scholar 

  7. Wolff HG: Headache and Other Head Pain. New York: Oxford University Press; 1948.

    Google Scholar 

  8. Mohan N, Kerr G: Spectrum of giant cell vasculitis. Curr Rheumatol Rep 2000, 2:390–395. Thorough but concise description of the pathogenesis of GCA that offers clues to its diagnosis and management. The concept of steroid resistance also is covered.

    Article  PubMed  CAS  Google Scholar 

  9. Petursdottir V, Johansson H, Nordborg E, Nordborg C: The epidemiology of biopsy-positive giant cell arteritis: special reference to cyclic fluctuations. Rheumatology 1999, 38:1208–1212.

    Article  PubMed  CAS  Google Scholar 

  10. AbuRrahma AF, Thaxton L: Temporal arteritis: diagnostic and therapeutic considerations. Am Surg 1996, 62:449–451.

    PubMed  CAS  Google Scholar 

  11. Ward TN, Levin M, Wong RL: Headache caused by giant cell arteritis. Curr Treat Options Neurol 2004, 6:499–505.

    PubMed  Google Scholar 

  12. Smetana GW, Shmerling RH: Does this patient have temporal arteritis? JAMA 2002, 287:92–101. This is a very clinically relevant, evidence-based article that deals with the decision-making involved in the evaluation and management of patients with GCA.

    Article  PubMed  Google Scholar 

  13. Huston KA, Hunder GG, Lie JT, et al.: Temporal arteritis. a 25-year epidemiologic, clinical, and pathologic study. Ann Int Med 1978, 88:162–167.

    PubMed  CAS  Google Scholar 

  14. Guttenberg SA, Emery RW, Milobsky SA, Geballa M: Cranial arteritis mimicking odontogenic pain: report of case. J Am Dent Assoc 1989, 119:621–623.

    PubMed  CAS  Google Scholar 

  15. Caselli RJ, Hunder GG, Whisnant JP: Neurologic disease in biopsy-proven giant cell (temporal) arteritis. Neurology 1988, 38:352–359.

    PubMed  CAS  Google Scholar 

  16. Classification Committee of the International Headache Society: International Classification of Headache Disorders II. Cephalalgia 2004, 24(suppl 1):68–69.

    Google Scholar 

  17. Redillas C, Solomon S: Recent advances in temporal arteritis. Curr Headache Rep 2003, 2:119–124. This is a very complete review article, with an emphasis on the clinical features of GCA.

    Google Scholar 

  18. Ward TN: Headache in cerebrovascular disease. In Office Practice of Neurology. Edited by Samuels MA, Feske S. New York: Churchill Livingstone; 1996:1144.

    Google Scholar 

  19. Jundt JW, Mock D: Temporal arteritis with normal erythrocyte sedimentation rate presenting as occipital neuralgia. Arthritis Rheum 1991, 34:217–219.

    Article  PubMed  CAS  Google Scholar 

  20. Pfadenhauer K, Weber H: Giant cell arteritis of the occipital arteries: a prospective color-coded duplex sonography study in 78 patients. J Neurol 2003, 250:844–849.

    Article  PubMed  Google Scholar 

  21. Barilla-LaBarca ML, Lenschow DJ, Brasington RD: Polymyalgia rheumatica/temporal arteritis: recent advances. Curr Rheumatol Rep 2002, 4:39–46. Outstanding review article that covers clinical, basic science, and therapeutic aspects of GCA.

    Article  PubMed  Google Scholar 

  22. Gold R, Fontana A, Zierz S: Therapy of neurological disorders in systemic vasculitis. Semin Neurol 2003, 23:207–214. A clinically useful and comprehensive review article about the management of vasculitis.

    Article  PubMed  Google Scholar 

  23. Ray-Chadhuri N, Kine DA, Tijani SO, et al.: Effect of prior steroid treatment on temporal artery biopsy findings in giant cell arteritis. Br J Ophthal 2002, 86:530–532.

    Article  Google Scholar 

  24. Nordborg E, Nordborg C: Giant cell arteritis: strategies in diagnosis and treatment. Curr Opin Rheumatol 2004, 16:25–30.

    Article  PubMed  Google Scholar 

  25. Hayreh SS, Zimmerman B: Visual deterioration in giant cell arteritis patients while on high doses of corticosteroid therapy. Ophthalmology 2003, 110:1204–1215.

    Article  PubMed  Google Scholar 

  26. Wilke WS, Hoffman GS: Treatment of corticosteroid-resistant giant cell arteritis. Rheum Dis Clin North Am 1995, 21:59–71.

    PubMed  CAS  Google Scholar 

  27. Hoffman GS: Treatment of giant-cell arteritis: where we have been and why we must move on. Cleve Clin J Med 2002, 69(suppl 2):SII117-SII20.

    Article  PubMed  Google Scholar 

  28. Krall PL, Mazanec DJ, Wilke WS: Methotrexate for corticosteroidresistant polymyalgia rheumatica and giant cell arteritis. Cleve Clin J Med 1986, 56:253–257.

    Google Scholar 

  29. Demaziere A: Dapsone in the long-term treatment of temporal arteritis [Letter]. JAMA 1989, 87:3.

    CAS  Google Scholar 

  30. De Vita S, Tavoni A, Jeracitano G, et al.: Treatment of giant cell arteritis with cyclophophamide pulses [Letter]. J Int Med 1992, 232:373–375.

    Google Scholar 

  31. Weyand CM, Kaiser M, Yang H, et al.: Therapeutic effects of acetylsalicylic acid in giant cell arteritis. Arthritis Rheum 2002, 46:457–466.

    Article  PubMed  CAS  Google Scholar 

  32. Nesher G, Berkun Y, Mates M, et al.: Low-dose aspirin and prevention of cranial ischemic complications in giant cell arteritis. Arthritis Rheum 2004, 50:1332–1337.

    Article  PubMed  CAS  Google Scholar 

  33. Airo P, Antonioli CM, Vianelli M, Toniati P: Anti-tumour necrosis factor treatment with infliximab in a case of giant cell arteritis resistant to steroid and immunosuppressive drugs [Letter]. Rheumatology 2002, 41:347–349.

    Article  PubMed  CAS  Google Scholar 

  34. Tan AL, Holdsworth J, Pease C, et al.: Successful treatment of resistant giant cell arteritis with etanercept. Ann Rheum Dis 2003, 62:373–374.

    Article  PubMed  CAS  Google Scholar 

  35. Andonopoulos AP, Meimaris N, Daoussis D, et al.: Experience with infliximab (anti-TNF alpha monoclonal antibody) as monotherapy for giant cell arteritis. Ann Rheum Dis 2002, 62:1116.

    Article  Google Scholar 

  36. Physician’s Desk Reference, edn 58. Montvale, NJ: Thomson PDR; 2004.

  37. Both M, Jahnke T, Reinhold-Keller E, et al.: Percutaneous management of occlusive arterial disease associated with vasculitis: a single center experience. Cardiovasc Intervent Radiol 2003, 26:19–26.

    Article  PubMed  CAS  Google Scholar 

  38. Amann-Vesti BR, Koppensteiner R, Rainoni L, et al.: Immediate- and long-term outcome of upper extremity balloon angioplasty in giant cell arteritis. J Endovasc Ther 2003, 10:371–375.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Section of Neurology, Dartmouth Medical Center, One Medical Center Drive, 03756, Lebanon, NH, USA

    Morris Levin MD

Authors
  1. Morris Levin MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Thomas N. Ward MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Levin, M., Ward, T.N. Horton’s disease: Past and present. Current Science Inc 9, 259–263 (2005). https://doi.org/10.1007/s11916-005-0033-4

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11916-005-0033-4

Keywords

  • Infliximab
  • Cluster Headache
  • Giant Cell Arteritis
  • Temporal Artery
  • Temporal Arteritis