VIDEO GAME-RELATED SEIZURES - A REPORT ON 10 PATIENTS AND A REVIEW OFTHE LITERATURE

Objective. To further describe the features, postulated pathophysiolog y, treatment, and outcome of seizures occurring while playing or watch ing video games (video game-related seizures (VGRS)). Design. We evalu ated retrospectively 10 patients with VGRS seen by us and reviewed 25 reported cases. Results. The 35 patients ranged in age from 1 to 36 ye ars (mean: 13.2); and 26 subjects (74%) were male. Eight individuals ( 29%) had prior infrequent nonfebrile seizures, 4 (11%) had febrile con vulsions, and 2 (6%) had a family history of epilepsy. VGRS consisted of generalized tonic-clonic seizures in 22 of 35 individuals (63%); ab sences in 2 (6%); simple partial seizures in 6 (19%); complex partial seizures in 4 (11%); and other manifestations in 4. Neurologic examina tion and computed tomographic and magnetic resonance imaging scans wer e normal. Electroencephalograms demonstrated generalized or focal, int erictal or ictal epileptic patterns in 11 of 21 patients (52%) and pho toparoxysmal responses in 17 of 32 (53%). Eleven of 15 individuals (73 %) treated with video game (VG) abstinence alone, 3 of 6 who received anticonvulsants but played VGs, and 7 of 12 treated with combined VG a bstinence and anticonvulsants had no further seizures. Conclusions. We postulate that a special convulsive susceptibility of selected neuron s in striate, peristriate, infratemporal, and posterior parietal corti ces to particular visual stimuli plays a major role in VGRS. VG abstin ence is the treatment of choice of VGRS. Anticonvulsant medication is suggested only for those individuals who continue to play VGs or suffe r from seizures triggered by other, unavoidable visual stimuli, or fro m unprovoked attacks.