The attending physician of Congress suggested that Mitch McConnell’s recent episodes of speechlessness were linked to “lightheadedness” caused by dehydration or lasting effects of a concussion the senator suffered in March.
But seven neurologists interviewed by the New York Times thought the episodes pointed to something more serious.
While several possibilities were suggested, including mini-strokes, doctors said that the spells appeared most consistent with focal seizures, which are electrical surges in one region of the brain.
These doctors also said that whether caused by seizures or mini-strokes or something else, spells like Mr. McConnell’s would not preclude most patients from working or socializing normally.
“Seizures have a stigma in our society, and that’s unfortunate because these are very brief electrical interruptions in behavior,” said Dr. Jeffrey Saver, a professor of neurology at U.C.L.A. “Between those rare episodes, which are usually well controlled with medicines, people function perfectly normally.”
Dr. Anthony Kim said details such as the direction in which people’s eyes are pointed during such an episode offer potential clues about the cause. Noting that both recorded episodes were extremely similar with McConnell focusing in the distance and not speaking for about 30 seconds, led him to believe the most likely possibility was a seizure.
- Mini-strokes can cause brief periods of impaired speech, but rarely produce the same symptoms each time.
- Focal seizures, on the other hand, are often triggered by an irregularity in one specific part of the brain, and are known to stop patients dead in their tracks, seeming to cut them off from their surroundings. Patients can often respond reflexively to questions during such an episode.
- Seizures can be caused by a bleed in the brain or scarring from a previous traumatic injury. Previous strokes can also cause seizures.
- Seizures can be triggered by blood sugar abnormalities, but if someone has had two seizures that cannot be explained in that way, neurologists said that would typically be enough for a diagnosis of epilepsy.
Dr. Gavin Britz, a neurosurgeon at Houston Methodist, said he would want to exclude Parkinson’s disease, which can also cause freezing episodes.
All the neurologists found it difficult to believe that McConnell’s episodes were caused by dehydration, noting that other symptoms would be apparent, and the patient wouldn’t likely be upright and able to recover without fluids.