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Sharp pain in left temporal area. Took zithromax for sinusitis. Worried for temporal arteritis

Nov 2013
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I have been having tenderness and pain on the left temporal area that radiates the forehead, eye and cheek. Even my face feels tender. I've had shooting pain occasionally in cheek or side of head. All on the left side. My PCP treated me for sinusitis with zithromax 500 qd x5 days. I felt better til the 5th day and sx's began to return. I also feel pressure in the sinus area & top of head too. I read about temporal arteritis, migraines and trigeminal neuralgia. Non of it sounds good. But my symptoms seem to reflect temporal arteritis the most. I'm a little scared about that. what do you think?
Posted Sat, 2 Mar 2013 in Headache and Migraines
Answered by Dr. Sudhir Kumar 12 minutes later

Thank you for posting your query.

I appreciate your list of differential diagnoses, as they are very accurate and reasonable, based on your symptoms.

I agree with you that temporal arteritis is the most likely, and definitely needs to be excluded. In addition to the symptoms you have described, occasional blurring of vision may occur, and that (vision decline) is the most undesirable complication of temporal arteritis.

For diagnosis, ESR (a blood test) can be easily done, which is elevated in this condition. Another simple test is arterial doppler ultrasound of the temporal artery. The confirmatory test is temporal artery biopsy, which is also a relatively minor procedure.

If ESR is high, one option is to use a short course of oral steroids (4-6 weeks), which is the treatment of temporal arteritis. This is done to avoid the biopsy of temporal artery.

If ESR is normal, your condition could also be muscle tension headache. In that case, use of medicines such as amitriptyline and naproxen would be useful, along with physiotherapy.

I hope it helps. I would be pleased to answer any follow up queries.

Wishing you good health,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist
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