RT Journal Article SR Electronic T1 Pseudobulbar Affect in Stroke in Statesmen: The Peculiar Case of Winston Spencer Churchill (P04.003) JF Neurology JO Neurology FD Lippincott Williams & Wilkins SP P04.003 OP P04.003 VO 78 IS 1 Supplement A1 Brooks, Benjamin YR 2012 UL http://n.neurology.org/content/78/1_Supplement/P04.003.abstract AB Objective: To review the evidence that Winston Spencer Churchill had pseudobulbar affect as a consequence of his stroke in 1953.Background Few statesmen have had as open a review of his medical condition as Winston Spencer Churchill who was Prime Minister of the United Kingdom. He had a possible stroke in 1949. The stroke that was associated with emotional lability occurred in 1953 with clinical details related in 1] W. Russell Brain, "Encounters with Winston Churchill," Medical History, vol. 44, 2000, 3-20, 2) Richard Gordon, An Alarming History of Famous and Difficult Patients. New York: St. Martin's Press, 1997, 3) Richard Lovell, Churchill's Doctor: A Biography of Lord Moran, New York: Parthenon, 1993 and 4) Lord Moran, Churchill: The Struggle for Survival 1945-60.Design/Methods: Churchill was examined 9 times by Lord Brain following his stroke in 1953. By one month after the stroke his dysarthria and dysphagia had improved but Churchill had loss of emotional control which had worsened as other deficits improved. Churchill noticed that he was "always rather blubbery". Multiple sources identified this clinical change and felt that Churchill could not attend upcoming government and political events lest the public learn of his stroke. The only treatment mentioned for this condition and Churchill's fatigue was repeated doses of benzedrine.Results: Descriptions of emotionality and its potential political consequences were found 9 times in Lord Moran's accounts and 4 times in Lord Brain's account. Other sources alluded to these changes but only the neurologist and treating physician accounts gave appropriate descriptive elements to establish the diagnosis based on historical records.Conclusions: Churchill's stroke related pseudobulbar affect was described in several medical and non-medical sources. It's late onset post stroke and resolution remains the best studied example of pseudobulbar affect in a public statesman to date.Disclosure: Dr. Brooks has received personal compensation for activities with Avanir Pharmaceuticals, Bayer Healthcare Pharmaceuticals, Biogen Idec, Genentech, Inc., and Teva Neuroscience. Dr. Brooks has received research support from Avanir Pharmaceuticals, Biogen Idec, NINDS, Novartis, and Teva Neuroscience.Wednesday, April 25 2012, 07:30 am-12:00 pm