Georgia-based psychologist analyzes Trump speech in Texas where body twitches and verbal tics seemed to travel from one side of his brain to another -- an epileptic event that is seen in people who've had a stroke

(The Daily Beast, Facebook)

Americans in recent months have seen many signs that their president, 80-year-old Donald Trump, is suffering from mental or physical deficits that might be caused by the onset of dementia, a stroke, or similar health event. Perhaps the most alarming sign came this past weekend when Trump was giving a speech in Texas. A report at Raw Story, under the headline "Twitching Trump had a 'distinct' and 'disturbing' event during speech: psychologist." Alexander Willis writes:

During his speech at NASA’s Johnson Space Center in Texas on Friday, President Donald Trump’s entire body twitched in a manner that one forensic psychologist argued was consistent with what’s known as a focal aware seizure or a partial seizure.

John Paul Garrison, a Georgia-based clinical and forensic psychologist, analyzed footage of Trump’s speech in a video published Saturday that he called “the most concerning footage” of the president he had analyzed yet.

“For the past few months, I have been showing various neurological concerns and some steep signs of decline from President Trump, but what we're going to start with today is extremely concerning,” Garrison said.

Garrison provides details about what you see during the Trump speech -- relevant portions of which  can be viewed at this YouTube link. Willis writes:

Captured during Trump’s remarks at a Congressional Space Medal of Honor presentation in Houston, Texas, the footage shows Trump boasting about the stock market's performance. While speaking, Trump briefly pauses mid-sentence as his body twitches.

“What you just observed was a distinct and concerning neurological event, and you got to watch it cross both hemispheres in his brain — I'll explain what I mean,” Garrison said, noting that his analysis was strictly his own opinion.

“You saw his right arm jerk, and then you saw him blink, you heard his voice hesitate, and then you saw his left arm jerk. You literally watched it travel across his brain. To be very clear, these were not simple muscle spasms; this is not something related to pain — you don't see any pain on his face. You actually watch it travel from one arm, to his eyes, to his voice, to his left arm.”

What is going on with Trump's health, and how could it affect his behavior? We do not have solid answers to those questions yet. But Garrison says Trump clearly is struggling with neurological issues:

Garrison went on to allege that Trump may have suffered from a focal aware seizure, an epileptic event that tends to be “less severe than generalized seizures” and is usually brief.

“Now, what this is very consistent with is something that we see in people that have had strokes called a focal aware seizure or a focal motor seizure, and this can be focused in one part in the brain, and occasionally, it can spread to both parts of the brain,” Garrison said.

“I'm not insisting that's what's going on with him, but it is clearly something neurological, whether it's post-stroke or something else.”

A second video, Dr. Garrison points out that Trump struggles with muscle issues that make it hard for him to annunciate certain words and contribute to spasms in his right elbow. In short, Garrison says Trump is losing control of his body, causing him discomfort. Some of Trump's symptoms become more obvious when other people are speaking, and Garrison says that probably is because Trump becomes agitated at having to listen to others.

An article at theconversation.com provides examples of times when Trump has appeared to be struggling with neurological issues. Authors Joyce Siette and Paul Strutt address numerous neurological issues that some experts in behavioral science associate with Trump. Ultimately, Siette and Strutt focus on frontotemporal dementia and its possible connections to the U.S. president:

While questioning Trump’s mental fitness for office, various commentators have suggested he has malignant narcissism, Alzheimer’s disease or frontotemporal dementia, and is experiencing accelerating cognitive decline and a “profound psychological crisis”.

The claim of frontotemporal dementia in particular has stuck. This form of dementia can affect judgement, empathy, language skills and impulse control.

Trump’s critics say frontotemporal dementia explains his escalating threats, profanities, and tendency to ramble.

But is frontotemporal dementia really the answer?

Diagnosing someone with this condition from afar is not only irresponsible – it’s impossible. It may also inadvertently give Trump an “out” for offensive but intentional behaviour, while increasing stigma for those who live with dementia. 

It should be pointed out, however, that many professionals who have commented publicly about Trump's condition have not been trying to make a diagnosis. Instead, like Garrison, they are stating opinions based on their observations of a man who happens to hold what many people consider the most important and demanding job in the world. One of the most prominent mental-health professionals regarding Trump's fitness for office is Dr. John Gartner, a longtime psychologist at at Johns Hopkins University. Here is more from Siette and Strutt:

Frontotemporal dementia describes a group of neurodegenerative disorders that mostly affect the frontal and temporal lobes of the brain. These are regions involved in behaviour, personality, language and decision-making.

Unlike dementia due to Alzheimer’s disease, frontotemporal dementia rarely begins with memory loss. Instead, early symptoms involve changes in social conduct, emotional regulation or language abilities.

There are several variants. The most common is behavioural-variant, which presents as a gradual decline in how a person behaves, interacts with others and expresses their personality.

Diagnosis is complex and cannot rely on observation alone.

To make a diagnosis, a multidisciplinary team of clinicians will examine the person’s personal and medical history. This includes information from family members, neurological examinations and formal cognitive testing to consider possible diagnoses.

Brain imaging, such as MRI or PET scans, are used to identify changes in the structure and function of the brain. In some cases, genetic testing may be used when family history suggests inherited risk.

A “possible” diagnosis requires someone to demonstrate at least three of six core features. These are: 

• disinhibition
• apathy
• loss of empathy
• compulsive behaviour
• hyperorality (excessive tendency to examine objects using the mouth)
• loss of executive functions, the set of cognitive abilities that underpin our ability to plan and make decisions.

Importantly, these features must also show clear progression over time.