This paper contains a review of the signs and symptoms of giant cell arteritis, especially speech and respiratory manifestations of the disease, which are demonstrated by a new case history. An elderly woman presented with speech that was falsetto, breathy, and marked by downward pitch breaks and phonation breaks. In addition, she had visual loss, headache, edema along the scalp and pharyngeal arteries, polymyalgia rheumatica, elevation of Westergren erythrocyte sedimentation rates, and positive arterial biopsy results. Her speech disorder recurred during an exacerbation. A vascular mechanism is proposed to explain her unusual speech, acute recurrence, and rapid recovery. This explanation (reversible ischemia of the laryngeal musculature) has been proposed by other authors in previous studies.