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Mitch McConnell's Seizures

Disclaimer: I am not Mitch McConnell's physician nor do I have any inside information about his current health. But if I showed any Internal Medicine resident a film of his two incidents where he stared blankly for 30 seconds and had no idea where he was, the diagnosis better be "Absence Seizure." If the doctor said dehydration, stroke, lightheaded, or hypoglycemia, I would make them watch it again.

Mitch McConnell has fallen at least two times this year, the most recent in March where he suffered a concussion and broken rib. He was absent from work for about 6 weeks. Any time an older person has a traumatic brain injury, even a mild concussion, there can be damage to the neurons (brain cells).

All seizures are caused by abnormal bursts of electrical impulses in the neurons and altered neurotransmitters (chemicals that carry impulses). A grand mal seizure causes loss of consciousness and violent muscle contractions. There is a period of confusion that lasts afterward for several hours. Absence seizures (also called petite mal) cause brief loss of awareness, staring blankly, sometimes rapid blinking or lip smacking (as we saw with Mr. McConnell) and sometimes hand movements (he gripped the lectern) . After 10-30 seconds the person comes out of it and can speak again. There is usually no memory of the event.

Both episodes, that were caught on camera in a public speaking event, did not create panic in his aides. This tells me that they have witnessed it before and most likely his physicians are aware of the condition. He's a Senator so he has the best health coverage possible. I suspect he has had a full work up including MRI scans, blood tests and EEG (electroencephalogram) which shows seizure activity. He is probably on medication for seizures already. If these were new incidents he would be whisked off to the hospital. I can picture his physicians telling his aides "He may have these episodes again. He's on medication and unless it changes in some way, don't rush him to the hospital every time."

Another explanation for his freezing could be Parkinson's, which can develop after a traumatic brain injury. Parkinson's does cause slowness and freezing episodes, but there would be other signs. Also he seemed unable to hear or understand the reporters and aide's questions, which is more like a seizure than a Parkinson's freeze.

Mr. McConnell is 81 years old and he looks it. I tell patients that they have a chronologic age and a physiologic age. Not all 81 years olds are the same. When poor health starts interfering with a persons work, it's time to retire. The same goes for Senator Diane Feinstein. It's too bad when politics prevent them from stepping down and basking in their prior success.


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