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Ask the Mental Health Expert Archives 2001-2004

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Freezing Spells

Q. I am a 33-year-old man in good physical health with a question about my mental health. Quite often when I'm in the middle of a sentence I'll "freeze" for 2 or 3 seconds. I'll stop talking, look straight ahead and in the words of my girlfriend, I "vanish." It's like I've stepped out of my body and I am not there any more.

I am usually unaware of these pauses, and afterward I continue the sentence or ask what I was talking about then continue. Last night, however, in the middle of a sentence I froze for 45 seconds to a full minute. I was unaware of the length of the pause and I thought I had paused for only a few seconds.

I don't know where I went in my head or why. As far as I knew I was just thinking for a few seconds; I am very worried and upset that I disappeared for so long. Can you tell me what this condition might be (I realize you can't diagnose me online), where I can find out more information about it and what kind of doctor I will need to see?

A. Thank you?it's always refreshing to hear from someone who realizes that diagnosis requires a thorough face-to-face evaluation! But, I believe I can point you in the right direction. There are several possible reasons why people may freeze for a few seconds when they are in the middle of a sentence, accompanied by some change in their thought processes or level of consciousness.

1. They may be experiencing extreme anxiety that interrupts their thought processes. 2. They may be experiencing "thought blocking", in which case some internal stimulus (such as a voice or noise) intrudes into their conscious stream of thought; 3. They may be experiencing an epileptiform disturbance of some type--that is, a seizure.

Various types of epilepsy--including petit mal and complex partial seizures--are capable of interrupting consciousness in this way. The individual may temporarily space out, be unaware of his surroundings, and experience some degree of amnesia or lost time. In the case of complex partial seizures--often due to an electrical disturbance in the temporal lobes of the brain--the person may also experience unusual odors or tastes (such as the smell of burning rubber) as part of the aura or premonitory phase of the seizure.

The appropriate professional for you to see, in my view, is a neurologist. He or she will do a comprehensive evaluation, probably including an electroencephalogram (EEG) that will help correlate your brain wave activity with these episodes. (Nowadays, 24-hour portable EEG telemetry is available, allowing the individual to go home wearing a sort of electronic hat). If a neurological evaluation turns up nothing of diagnostic importance, I would then suggest that you consult a psychiatrist to see if some other process is interfering with your speech and thinking. Good luck in getting to the bottom of this!

December 2003

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