


Senate Minority Leader Mitch McConnell (R-KY) was medically cleared after a concerning speech delay while answering questions from reporters at a Kentucky press conference on Wednesday, but the diagnosis has given some members of the medical community pause.
A McConnell aide told the Washington Examiner on Wednesday that the senator, 81, "felt momentarily lightheaded" at the press conference and that he would be seeking a physician's guidance.
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After consulting with McConnell's neurologist, Brian Monahan, attending physician to the United States Congress and Supreme Court since 2009, cleared the minority leader to resume his regular schedule, noting that "occasional lightheadedness is not uncommon in concussion recovery and can also be expected as a result of dehydration."
New: Capitol attending physician Dr. Brian Monahan says he talked with McConnell & his neurology team. He says McConnell is “medically clear” to keep his sked
— Andrew Desiderio (@AndrewDesiderio) August 31, 2023
“Occasional lightheadedness is not uncommon in concussion recovery and can also be expected as a result of dehydration.” pic.twitter.com/Ti35frbWXn
McConnell was diagnosed with a concussion and a rib fracture in March after a fall in a D.C. area hotel, from which it took him nearly six weeks to recuperate and return to the Senate.
A McConnell aide told reporters that the senator was also lightheaded in July, when McConnell first had difficulty speaking to reporters, which is medically called an episode of aphasia.
Carole Lieberman, a forensic psychiatrist and a diplomat of the American Board of Psychiatry and Neurology, told the Washington Examiner that she believes that Monahan's diagnosis is really "a way to calm the public" and attempts to offer "benign explanations for something a lot more serious."
Although Lieberman has not examined McConnell or his medical records, she said that the most likely explanation for both events is a transient ischemic attack or a TIA.
TIAs, often referred to as "mini-strokes," are temporary blockages in the blood vessels in the brain that lead to momentarily low oxygen supplies, resulting in neurological events such as slurred or impaired speech or movement. The symptoms of TIAs can last from several minutes to up to 24 hours, after which time the effects usually result in a permanent deficit and can be classified as a stroke.
The psychiatric implications of the most recent attack, however, were of particular interest to Lieberman.
"This last moment ... came after he was asked the question whether he was going to run in 2026 [due to recent health problems]. Now, as a psychiatrist, what that says to me is that that was an overwhelming thought," said Lieberman. "Facing his own mortality, was such a shocking or unpleasant thought that it brought on ... a cardiovascular neurological response."
Although momentary aphasia can be a symptom of concussion, according to the American Association of Neurological Surgeons, Lieberman said that aphasia is typically an acute symptom, meaning that it occurs closer to the initial incident rather than several months afterward.
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Other health professionals in the field of neurology and geriatric medicine, however, were unwilling to respond to the Washington Examiner's request for comment because they did not have access to McConnell's medical records.
"No one knows what [McConnell] does behind the scenes," Lieberman said, "but he's not taking all of his issues seriously enough."