Why Do People Freeze? Mini Strokes, Panic Attacks and Other Reasons

After Senate Republican Leader Mitch McConnell's unexplained pause on Wednesday during a press conference at the Capitol, people have been left wondering why people freeze.

As the 81-year-old Kentucky senator stood at the podium while speaking to reporters, he suddenly appeared to lose his train of thought. He then proceeded to stare into space until he was ushered away from the podium by his aides, returning minutes later to finish the press conference.

McConnell has since insisted that he is "fine" and is still able to do his job, and has not given further information about the incident. But while it is not publicly known what actually happened at that podium, it has raised the question: Why do people freeze? There are several potential reasons, neurological experts (who have not treated McConnell) told Newsweek.

"I have learned to never speculate on someone's neurological diagnosis...without personally examining them and receiving permission from families to discuss the case," Michael Okun, director of the Fixel Institute for Neurological Diseases at the University of Florida, told Newsweek. "McConnell's public event does, however, offer us an opportunity to educate the public and to elevate our neurological care for all."

What neurological conditions could cause an episode like this to happen?

"This sort of freezing—i.e. speech arrest, staring into space of sudden onset and non-responsiveness—can be seen in complex partial seizures in epilepsy, transient ischaemic attacks (mini-strokes), psychological issues and fugue states, in anxiety and panic disorder to name a few," Peter Silburn, co-director of the Asia-Pacific Center for Neuromodulation at the Queensland Brain Institute, told Newsweek.

"These certainly need full neurological workups such as brain imaging and electroencephalography to exclude dysfunction related to structural changes in certain areas of the brain and seizures," he said.

The medical history of an individual is also important. "Previous head trauma or even common medications can contribute to the clinical picture," Okun said. "A previous fall with traumatic brain injury will increase the risk for future seizures."

In March this year, McConnell suffered and concussion and was rushed to the hospital after a fall in a hotel in Washington, D.C.

Freezing episodes may also be an indicator of some kind of degenerative disease, according to Patrick McNamara, an associate professor of Neurology at Boston University School of Medicine.

"Aside from acute anxiety which I doubt McConnell has, given that he is in front of audiences and reporters all the time the only other condition that I know of that can cause that kind of freezing is Parkinson's Disease," McNamara told Newsweek.

Okun agreed, saying: "Degenerative diseases such as Parkinson's, Lewy Body Disease, Alzheimer's and others may be associated with cognitive fluctuations or even seizures so these must be considered."

In summary, freezing episodes may result from a range of conditions, including:

• Seizures
• Mini-strokes
• Anxiety/panic attacks
• Degenerative diseases

"There are many potential causes for an acute mental status change and it is important to facilitate immediate medical care, as depending on the cause, the outcome may be critically dependent on time; how fast a potential therapy is administered," Okun said.

"The typical approach following such an event is a comprehensive in-person neurological examination, a review of the medical record, a quick check for infections, a brain imaging study and possibly an EEG to check for seizure activity in the brain."

McConnell's office has so far declined to say whether he has visited a doctor since the episode.