Video Games Can Spark Photosensitive Seizures

Vital Signs: Summer 2010

On any given day, 60 percent of young people in America play video games, and those who do spend an average of nearly two hours at it. Those findings come from a recent Kaiser Family Foundation study on media use among kids 8 to 18 years of age. But with that frequency and intensity of video game use comes the risk of visually induced seizures.

While these so-called “photosensitive seizures” are not common, they are the most common form of “reflex epilepsy” and are almost certainly more prevalent than physicians know. In one study, seizures triggered by electronic media represented approximately 10 percent of all new cases of epilepsy in young people between the ages of 7 and 19.

Following a 1997 incident in Japan, when about 700 children went to hospitals after experiencing seizures during a Pokémon cartoon broadcast, it became clear that photosensitivity was probably not rare. Three-quarters of those children had no known seizure history.

Subsequently, video game manufacturers began providing warnings about the risk of seizures from video games. Video games are more likely than TV to trigger seizures because users typically look at the screen from a short distance and for extended periods without breaks.

When taking a routine history from a young person and family members, physicians can help uncover symptoms or behaviors suggestive of photosensitive seizures. Inquire about the signs of a partial seizure, which include abrupt mood changes, altered vision, incontinence, confusion, involuntary or unusual movements, and lack of responsiveness.

Although many people have trouble turning off video games because they are so “into it,” extreme difficulty may suggest the presence of subtle seizures. And because seizures can impair a player’s skills and performance, gamers experiencing seizures may develop an especially strong desire to continue playing until they regain their facility.

Here’s how patients can reduce vulnerability to seizures while playing video games:

• Take frequent breaks;
• Avoid playing when fatigued or sleep-deprived;
• Move back from the screen so it fills a smaller portion of the visual field;
• Dim the screen, use a monitor glare filter, or wear dark lenses;
• Cover one eye.

If seizures occur only in response to a specific visual trigger or under certain conditions, the patient can verify the cause/effect by temporarily halting exposure to the presumed triggering stimulus to see if symptoms remit. Some patients with extreme visual sensitivity may need to avoid exposure entirely.

Only about 25 percent of those with photosensitive seizures outgrow the condition, usually in their early twenties. However, our current understanding is that such seizures do not progress into the types of epilepsy involving spontaneous seizures.

– Michael Rich, M.D., M.P.H.
Children’s Hospital Boston