WRITER: AMY LILLARD
CONTACT: DAVE PEDERSEN
2130 Medical Laboratories
Iowa City IA 52242
(319) 335-8032; fax (319) 335-8034
Release: Oct. 1, 1999
UI dentist warns of disguised disease
IOWA CITY, Iowa -- Cranial arteritis, a condition
typically marked by headaches and jaw pain associated with eating, may result
in permanent blindness if untreated, a University of Iowa College of Dentistry
Cynthia L. Kleinegger, D.D.S., assistant professor
in the UI Department of Oral Pathology, Radiology, and Medicine, detailed
the disease in an article published in the August 1999 issue of the Journal
of the American Dental Association. Kleinegger co-authored the paper with
Gilbert E. Lilly, D.D.S., professor and departmental executive officer.
"Since cranial arteritis frequently mimics other disorders,
it is easily misdiagnosed and the potential outcome can be devastating," Kleinegger
said. "It is important for all health care professionals to be familiar with
Cranial arteritis is an inflammatory disease that
primarily affects cranial arteries and results in decreased blood flow to
the tissues they supply. Pain results when functioning muscles do not receive
enough blood -- in this case the muscles that move the lower jaw and occasionally
the muscles of the throat and tongue. When the blood flow to the visual pathway
is decreased, the patient may suffer permanent blindness.
The cause of cranial arteritis is unknown, but there
is some evidence of genetic predisposition. Once diagnosed, cranial arteritis
is treated with steroids.
The condition occurs primarily in people over age
50, with more than 17 cases per 100,000 individuals discovered each year in
that age group. The prevalence increases with age and 850 cases per 100,000
individuals over the age of 85 are diagnosed annually. The frequency of the
condition in older people suggests that physicians should seriously consider
cranial arteritis when elderly patients complain of headaches and pain associated
"Since blindness may be sudden in onset, a suspected
case of cranial arteritis constitutes a medical emergency," Kleinegger cautioned.
The article described two cases of cranial arteritis
in which both patients also exhibited symptoms suggestive of other conditions,
such as temporomandibular joint disorder or myofascial pain. In one of the
cases, the patient had consulted several healthcare providers, which resulted
in a delay of the appropriate diagnosis.
Kleinegger identified a wide variety of symptoms that
may be associated with cranial arteritis. Among the key symptoms that could
suggest the condition are discomfort associated with eating, typically resolving
after chewing is stopped, headaches and a lack of response to treatment for
other diagnoses that have been made.
"These symptoms can clue a health care professional
to cranial arteritis, but it is important to remember that all the pieces
may not be there," Kleinegger said.
Kleinegger said that during her three years as a UI
faculty member she has diagnosed two cases of cranial arteritis. Since her
paper was published, she has discovered another patient with the condition.