The emperor with the shaking head: Claudius’ movement disorder
By Jane E. Rice
Journal of the Royal Society of Medicine, Vol.93 (2000)
Introduction: The medical conundrum posed by the Roman emperor Claudius remains one of the most intriguing of the ancient world. Born in 10 BC, Tiberius Claudius Drusus Nero Germanicus survived the internecine conflicts within the Julian-Claudian house to become emperor of Rome in 41 AD at the age fifty, after the murder of his nephew Caligula. He ruled the Roman empire for fourteen years, until his death in suspicious circumstances at the age of sixty-four. What is remarkable about this achievement is that for much of his life he suffered from a disabling illness, characterized by such striking outward manifestations that his family called into question his soundness of mind. Yet accounts of his long and apparently successful reign render the the cumulative impression that neither his intellectual function nor his lifespan was adversely affected by his condition.
The nature of this illness has been a source of speculation; suggestions have included cretinism, hydrocephalus, epilepsy, infantile paralysis and alcoholism. However, none of these diagnoses is wholly consonant with the historical picture of a chronic disorder of motor function sparing the intellect and compatible with normal survival. Perhaps the most plausible suggestion to date has been that of cerebral palsy. The information extracted from historical sources suggests that Claudius’ condition might most appropriately be placed in the general category of a movement disorder. Re-examination of the evidence from this point of view provides a new perspective on the emperor’s illness, and raises the possibility that Claudius’ condition may have been a form of dystonia.
The surviving depictions of Claudius’ illness combine to form a case history of tantalizing brevity. Only three historical sources provide medical information of any significance. The most objective and detailed in the biography written by Gaius Seutonius Tranquillus. Born around 70 AD, Seutonius, a court official who directed the imperial libraries and correspondence, is thought to have used his access to imperial records to furnish material for his Lives of the Caesars. The historian Dio Cassius, a native of Nicaea born around 163 AD whose political career took him to the Roman Senate, provided a later profile. The third and rather more unlikely source is the Apocolocyntosis (‘Pumpkinification’) attributed to Lucius Anneaus Seneca. In this posthumous satire on Claudius’ deification, many of Claudius’ physical peculiarities are lampooned. As Seneca – philosopher, author and tutor to Nero – was a contemporary of Claudius, we can reasonably assume that the abnormal movements emphasized by Seneca had a basis in fact.