By David Morgan and Makini Brice
WASHINGTON (Reuters) -U.S. Senate Republican leader Mitch McConnell sidestepped questions about his health in his return to the Capitol on Tuesday, six days after freezing up for a second time while speaking in public.
The 81-year-old lawmaker addressed the Senate hours after the doctor of Congress said in a statement that the two episodes did not appear to be the result of a stroke or seizure, but offered no explanation of what caused McConnell to stand speechless and wide-eyed during a press conference last Wednesday.
"Now, one particular moment of my time back home received its fair share of attention in the press over the past week. But I assure you, August was a busy and productive month for me and my staff," McConnell said.
He appeared thin and wan on the Senate floor, and spoke in a baritone that wavered from time to time.
Dr. Brian Monahan wrote in a one-paragraph letter that he had reached his conclusion after a comprehensive neurological assessment that included the results of brain MRI imaging, an EEG (electroencephalogram) study and consultations with several neurologists.
The incidents have raised questions about McConnell's health and his future as the longest-serving party leader in Senate history. Republican lawmakers said the physician's letter was part of an effort by McConnell to be more transparent.
But the Republican leader ignored repeated questions about his health from reporters as he made his way to and from the Senate chamber, where he delivered a six-minute speech that contained a single oblique reference to the latest incident.
McConnell was sidelined for weeks after he tripped at a Washington dinner on March 8 and was admitted to a hospital for treatment of a concussion and a minor rib fracture. He returned to the Senate in April.
"It appears that it's harder to recover from a concussion when you're 81 years old than maybe he thought. But he's, he feels like he's up to the task and I think that's the case," Republican Senator John Cornyn told reporters.
"I've told Senator McConnell, I'm going to support him as long as he wants to do the job and can do the job," added Cornyn, one of several Republicans who expressed support for McConnell's continued leadership.
In his letter, Monahan wrote: "There is no evidence that you have a seizure disorder or that you experienced a stroke, TIA (transient ischemic attack) or movement disorder such as Parkinson's disease. There are no changes recommended in treatment protocols as you continue recovery from your March 2023 fall."
McConnell's office declined to answer a request for further detail on what doctors believe caused the incidents. His staff released the doctor's letter as the Senate reconvened after a lengthy summer recess.
Two neurologists not involved in McConnell's treatment, who spoke to Reuters, said the MRI and EEG tests would not necessarily rule out the possibility of a seizure because those tests would not automatically show evidence of one.
"In most patients with a seizure disorder, an EEG will oftentimes come back normal in between episodes, and is more helpful to rule in a seizure if it records some abnormal activity between episodes or even captures an episode," said Anthony Kim, medical director for the University of California San Francisco stroke center.
Kim said MRI results often come back normal for seizure patients as well because they don’t show brain activity.
Twice in the last six weeks, McConnell has frozen up during public appearances.
The latest incident occurred last Wednesday during a press conference in Kentucky, where he froze for more than 30 seconds and stared into space before being escorted away. A similar incident occurred in the U.S. Capitol on July 26 as McConnell spoke to reporters.
His office at the time described the events as being the result of lightheadedness and dehydration.
The Senate will have urgent work ahead, including passing legislation to keep the government funded past Sept. 30, when the fiscal year ends.
(Reporting by David Morgan and Makini Brice, additional reporting by Katharine Jackson, Richard Cowan, Jasper Ward and Patrick Wingrove; Editing by Scott Malone and Howard Goller)