As far as the great names of what came to be the death rattle of the Julio-Claudian Dynasty of Rome, people seem to more easily recall the likes of sex-crazed, murder-happy Caligula and mother-killing, play-the-lyre-while-Rome-is-burning Nero. It is less likely there will be an HBO/Showtime sultry telling of the life and times of Tiberius Claudius Drusus Nero Germanicus, more simply known as emperor Claudius.
After the assassination of Caligula, in walked a thirty year old man with a shaking head, weak hands and knees, a stutter, with the propensity for dripping out the nose and mouth whenever he was excited. It is thought that this presentation may have saved him from many an assassination, as he did not appear as a threat. This was until he was supposedly poisoned by his last wife, Agrippa the Younger, mother of Nero. Or died of nature causes, as any historical portrayal of his health was generally poor.
This is a problem I keep running into during this last half of the World Leaders series; No one can be really sure how someone died before these last few centuries. I have come to the conclusion that most historians are hopeless gossips who happen to have pens in their hands. So, much to my demented pleasure, I’ll just have to explore most of the possibilities.
What we have as far as signs and symptoms are thus: no physical deformity, stammering speech or dysphasia or dysarhtia, a marked limp or dystaxia, and exacerbation of symptoms when angered or stressed. Death came at the age of 63 years old, potential from poisoning, illness, or old age (by first century standards). Claudius himself claimed he played up symptoms at certain times to his advantage. It is also reported that when seated and calm this Caesar would appear tall and without malady, sometimes with dignitas.
Modern medical assessments of Claudius have landed on either polio, Tourette Syndrome, or cerebral palsy. Poliomyelitis, the favored diagnosis of Claudius in the early 20th century (likely due to its prominence at the time and no vaccine available until 1950), serves to explain the limp, due to the paralyzing effect of the poliovirus on nerves. It does not serve to explain how Claudius in the first century could have survived potential viral attack on the nerves that allow one to swallow or breathe, ruling out bulbar polio (polioviral attack on the brain stem) and a lack of deformity such as club foot is also not mentioned by Roman historians. Also polio usually effects one limb or the other, paralyzing at the root of the limb and moving outward at onset, and Claudius has noted shaking of the head and both hands and both knees. So let’s not go with polio.
Gilles de la Tourette Syndrome (GTS or simply TS) could explain the change in the symptoms, as some people with Tourette Syndrome have reported an ability to suppress certain “tics” for a limited amount of time, maybe similar to Claudius’ presentation on his throne, calm and dignified. However this is less likely to explain his unsteady gait, or his limp and generalized weakness.
Finally, cerebral palsy is characterized by three distinctive types. In the case of CP with spastic paralysis, abnormal stiffness and contraction in groups of muscles of: all four limbs, commonly with legs more so affected than the arms (diplegic), the limbs on one side of the body, commonly with the arm more so affected than the leg (hemiplegic), or all four limbs affected severely, with no pattern of symmetry or weaker limb noted. Athetosis CP produces writhing movements as well loss of coordination and balance. And lastly ataxia CP presents with disturbed sense of balance and depth perception, as well as hypotonia (weak muscle tone), staggering walk, and unsteady hands. CP is commonly associated with epilepsy and other central nervous system disorders and 30% to 50% of those with cerebral palsy suffer some form of mental retardation, while the remaining percentage can be highly intelligent.
Personally, although cerebral palsy with ataxia is the rarest form, it describes Claudius’ symptoms best. However the medical term “claudication” or “claudicating”, obviously associated with the Roman emperor, does not describe cerebral palsy. It instead describes the limp generated by cramped leg muscles due to peripheral vascular disease, caused by narrowing and occlusion of blood vessels in the thighs, calves, and buttocks. “Angina of the ass”, if that helps anyone remember this condition named after this week’s world leader.