Was Julius Caesar's epilepsy due to a brain tumor?
Two thousand thirty-eight years later, in the setting of a similar care presentation, a physician would take a detailed history and perform a clinical and neurological examination. A preliminary diagnosis would be entertained and followed by electroencephalography and magnetic resonance of the brain with and without paramagnetic contrast for diagnostic confirmation. The proper medical or surgical treatment would then be instituted. A reconstruction of the clinical history of Julius Caesar (100-44 B.C.) has been attempted from available information from literature. Although a definite conclusion obviously cannot be made, a differential diagnosis provided with a tentative hypothesis is presented. The patient had late onset of seizures in the last two years of his life, headaches, personality changes. Upon reexamination of existing Julius Caesar iconography, busts, statues and minted coins no skull deformities have been noted. Identification of a skull deformity as described by Suetonius would have confirmed the suspicion of meningioma involving the convexity of the cerebral hemispheres. Meningioma or slow-growing supratentorial glioma may well have been responsible for this man's illness. Who knows how the course of history might have been changed... Probably not at all.
Gomez
J G
JG
Division of Neurological Surgery, Holy Cross Hospital, Fort Lauderdale, USA.
Kotler
J A
JA
Long
J B
JB
D001932:Brain Neoplasms / Q000266:history*; D004827:Epilepsy / Q000266:history*; D005197:Famous Persons; D049690:History, Ancient; D006801:Humans; D008297:Male; D018644:Roman World