December 1, 2021

I, Science

The science magazine of Imperial College

<em>Cassius: But soft, I pray you. What, did Caesar swound? Casca: He fell down in the market place and foamed at mouth and was speechless. Brutus: 'Tis very like. He hath the falling sickness.</em> Elly Magson investigates Julius Caesar's malady, 2000 years on.


Julius Caesar’s health problems may have been caused by strokes, not epilepsy, according to recent research from Imperial College.

The medical ailments that affected Caesar were documented by ancient authors and are still discussed by today’s historians.

Caesar’s symptoms were mainly described by Plutarch and Suetonius, historians both born after Caesar’s death in 44BC. The symptoms described include falls, headaches, giddiness and vertigo, and have often been taken by modern scholars to suggest a diagnosis of epilepsy.

However, Francesco Galassi and Hutan Ashrafian from the Department of Surgery and Cancer at Imperial have re-assessed the historical documents and found that the symptoms could be attested to cerebrovascular disease, or strokes.

The Battle of Thapsus
The Battle of Thapsus

Strokes are caused by a disruption of the blood supply to the brain, resulting in a lack of oxygen delivery to the brain, which can cause weakness in the limbs and disruption of speech. Weakness in the limbs, or paresis, could have been the cause of Caesar’s inability to stand for senators honouring him, or of the fall that led him to be carried away from the Battle of Thapsus in 46BC. According to Dr. Galassi, a diagnosis of cerebrovascular disease would be more logical to fit with these descriptions.

Caesar may have actually preferred a diagnosis of epilepsy. Known as the ‘sacred disease’, and previously linked with genius, its connotations would have been more befitting for a member of Roman nobility. Alexander the Great was another possible sufferer of epilepsy, and Caesar and his successor Octavian may have wanted to emulate this great leader.

Francesco Galassi says that the research has been well-received, but that there must be an attitude shift in how we view historical figures to lead to better understanding: “We look at them as marble statues and stick to the accepted theories. In my opinion we must respect the sources but give them a fresh, critical eye”.

Elly Magson is studying for a MSc in science communication

Images: Julius Caesar by Jule Berlin (Shutterstock); The Battle of Thapsus (Wikimedia Commons)

Citation: Galassi, F.M. & Ashrafian, H. (2015) Has the diagnosis of a stroke been overlooked in the symptoms of Julius Caesar?. Neurological Sciences. doi: 10.1007/s10072-015-2191-4