Read more...

The world-wide explosion of video games and the attendant problems have been unnoticed by the medical profession, except by doctors who are addicted to these games and deny that such a problem exists. Single cases of Space Invader wrist tendonitis and Space Invader epilepsy have, however, recently been reported. We describe a case of highly selective 'Space Invader epilepsy'. Read more...

Human epileptic photosensitivity has been studied in several ways. (a) Visual stimulation that resembles the stimulation normally responsible for seizures, such as that from televisions or videogames, both of which typically use cathode ray tubes in which the display is created in a flickering pattern. Such stimulation is often rendered yet more epileptogenic by programmes with content that also involves flashing or patterned material. (b) Elementary visual stimuli that enable inferences to be drawn concerning the physiological trigger mechanisms. The topographic distribution of epileptiform EEG activity in response to such stimuli has complemented this approach, leading to the inference that the trigger is cortical and requires sychronised mass action of neurons. (c) Stimuli that avoid paroxysmal EEG activity and permit an investigation of the subepileptic response to visual stimuli, using the evoked potential. This has revealed abnormalities in the cortical mechanisms that control the response to strong visual stimulation. Read more...

Background: Video game seizures have been reported in photosensitive and non-photosensitive patients with epilepsy. The game Super Mario World, has led to many cases of first seizures. We examined whether this game was indeed more provocative than other programs and whether playing the game added to this effect. Methods: We prospectively investigated 352 patients in four European cities, using a standard protocol including testing of a variety of visual stimuli. We correlated historical data on provocative factors in daily life with electroencephalographic laboratory findings. Results: The video game, Super Mario World proved more epileptogenic than standard TV programs and as provocative as programs with flashing lights and patterns. Most striking was the fact that video game- viewing and-playing on the 50 and 100 Hz TV was significantly more provocative than viewing the standard program (P < 0.001, P < 0.05 respectively). Playing the video game Mario World on a 50 Hz TV, appeared to be significantly more provocative than playing this game on the 100 Hz TV (P < 0.001). Of 163 patients with a history of TV-, VG- or CG-seizures, 85% of them showed epileptiform discharges in response to photic stimulation, 44% to patterns, 59% to 50 Hz TV and 29% to 100 Hz TV. Conclusions: Children and adolescents with a history of video game seizures are, in the vast majority, photosensitive and should be investigated with standardised photic stimulation. Games and programs with bright background or flashing images are specifically provocative. Playing a video game on a 100 Hz TV is less provocative . Read more...

People of all ages, but especially children and adolescents, are increasingly exposed to visual stimuli. Typical environmental stimuli that can trigger epileptic seizures in susceptible persons are televisions (TVs), computers, videogames (VGs), discotheque lights, venetian blinds, striped walls, rolling stairs (escalators), striped clothing, and sunlight reflected from snow or the sea or interrupted by trees during a ride in a car or train. Less common stimuli are rotating helicopter blades, disfunctioning fluorescent lighting, welding lights, etc. New potentially provocative devices turn up now and then unexpectedly. During the last decades especially, displays have become increasingly dominant in many of our daily-life activities. We therefore focus mainly on the characteristics of artificial light and on current and future developments in video displays and videogames. Because VG playing has been shown also to have positive effects, a rating system might be developed for provocativeness to inform consumers about the content. It is important that patients with epilepsy be informed adequately about their possible visual sensitivity. Read more...

We determined whether epileptic clinical manifestations evoked by playing video games (VG) differ from those evoked by intermittent photic stimulation (IPS) or striped patterns (P). We exposed nine children who had TV- and VG-evoked seizures in daily life to 12 VG after standardized photic stimulation and pattern stimulation. Their EEGs were recorded continuously, analyzed, and then correlated with a video of their behavior. Similar types of clinical signs were seen during VG, P, and IPS, but the signs we observed were more subtle during the VG. Eight patients showed a clear lateralization. A new observation was the lowering of the eyelids to a state of half-closed. Our study suggests that the type of visual stimulus provoking a photoparoxysmal response or seizure is not particularly relevant. The children belonged to different epilepsy groups, and our findings add to the discussion on the boundaries of the epilepsy types. Read more...

People of all ages, but especially children and adolescents, are increasingly exposed to visual stimuli. Typical environmental stimuli that can trigger epileptic seizures in susceptible persons are televisions (TVs), computers, videogames (VGs), discotheque lights, venetian blinds, striped walls, rolling stairs (escalators), striped clothing, and sunlight reflected from snow or the sea or interrupted by trees during a ride in a car or train. Less common stimuli are rotating helicopter blades, disfunctioning fluorescent lighting, welding lights, etc. New potentially provocative devices turn up now and then unexpectedly. During the last decades especially, displays have become increasingly dominant in many of our daily-life activities. We therefore focus mainly on the characteristics of artificial light and on current and future developments in video displays and videogames. Because VG playing has been shown also to have positive effects, a rating system might be developed for provocativeness to inform consumers about the content. It is important that patients with epilepsy be informed adequately about their possible visual sensitivity. Read more...

Home computer game playing appears to be one of the social and leisure phenomena of the nineties, yet there is still little known about the acquisition, development, and maintenance of computer game playing among children and adolescents. A survey of 147 eleven-year-old computer game players attending a summer camp revealed that their main reasons for playing were for fun, for a challenge, because there was nothing else to do, and because their friends did. Males played computer games significantly more regularly than did females and were significantly more likely to play sports simulation games and violent games. Females were found to play platform games and puzzlers significantly more than did males. It is suggested that computer game playing for most children is a fairly absorbing and harmless activity but that, for a small minority of children, it may be problematic. Read more...

As the Internet has become rapidly and widely integrated into society, Internet addiction has become a growing psychosocial problem. However, epileptic seizure, another out-of-the-ordinary health problem, is often neglected in this regard. Ten patients who experienced epileptic seizures while playing the newest genre of electronic games-Massively Multiplayer Online Role-Playing Games (MMORPGs)-were investigated. Patients were predominantly male young adults, and most of the events were generalized tonic-clonic seizures, myoclonic seizures, and absences. These patients should be categorized into idiopathic generalized epilepsies. Even though photosensitivity was an important factor, behavioral and higher mental activities also seemed to be significant seizure precipitants. Results demonstrated that MMORPG-induced seizures were not analogous to the ordinary video game-induced seizures. Significantly, an epileptic seizure warning did not always appear on the websites of MMORPGs and instructions for the software. While the prevalence of MMORPG-induced seizures remains unknown, it may exceed our expectations and impact our society. Not only for clinical neurologists but also for the primary physicians, educators, sociologists, and global online game publishers, there should be an awareness of this special form of reflex seizures in order to provide an appropriate health warning to MMORPG players. Read more...