The New York Times reports:

A four-line letter, signed by the attending physician of Congress and released by Senator Mitch McConnell on Thursday, suggested that his recent spells of speechlessness were linked to “occasional lightheadedness” perhaps brought on by his recovery from a concussion last winter or “dehydration.”

But seven neurologists, relying on what they described as unusually revealing video of Mr. McConnell freezing up in public twice recently, said in interviews Thursday and Friday that the episodes captured in real time likely pointed to more serious medical problems afflicting the longtime Republican leader.

Some of the neurologists, while cautioning that they could not diagnose the minority leader from afar, said that the letter and other comments from Mr. McConnell’s office appeared to fall short of explaining why he abruptly stopped speaking during news conferences in late July and again on Wednesday.

“If I gave that tape to a medical student and that was his explanation, I’d fail him,” said Dr. Orrin Devinsky, a professor of neurology at the NYU Grossman School of Medicine, referring to the account given by the attending physician of Congress on Thursday. “Medically, these episodes need to be taken seriously.”

The neurologists said that the episodes justified close medical attention and could prompt treatment to keep them from recurring. 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.

The senator’s aides have not revealed what type of follow-up care Mr. McConnell may be receiving. Doug Andres, a spokesman for the senator, said on Friday he had nothing to add beyond the letter by the Congressional physician, Dr. Brian P. Monahan, who did not respond to requests for comment.

More details about the medical history of Mr. McConnell, 81, including whether he has been having such episodes off camera, would also help rule out other possible explanations for the spells, neurologists said.

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, doctors said.

“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.”

Still, experts said that seizures carried some elevated risk of cognitive or behavioral problems and could affect older patients differently. [Continue reading…]