Gamer Health - Recognizing and Avoiding Seizures

Seizures can be hard to detect. They can be stealthy, like a really good internet troll. When you hear the word seizure, you may conjure an image of tremors, twitching or jerking movements. If you’ve never seen one, check out YouTube, or just think of your friends trying to dance to dubstep. The reality is that seizures can present in a variety of ways. They can occur at various ages for the first time. You can have your first episode well after age 30. You don’t have to be an epileptic to have a seizure. We have all seen the warnings about seizures at start of many games, and they have been studied widely since they were first reported in 1981 (aka Space Invader epilepsy). However, despite this, consumers and physicians have a hard time making the diagnosis. You may think that it is an uncommon issue, but many seizures escape detection and diagnosis by physicians. Left unnoticed, their disabling after-effects can linger, it can be hard to pinpoint the cause of disability. The best person to realize that something is wrong is the one that spends the most time with the gamer.

A seizure is a burst of abnormal electrical activity in the brain. With videogames, they can be induced by flashing of an electronic screen, rapid movements and bright colors. While many are prone to seizures, there are a number of conditions and factors that can trigger a seizure in an otherwise “normal” individual. Specific to gaming, stress, excitement and emotional upset (aka Donkey Kong Rage) can affect sleeping or eating habits and make you more prone to attacks. A 22 year old man had an isolated attack after playing a game for hours after being sleep deprived (Case #4). http://www.ncbi.nlm.nih.gov... In terms of diet, be wary of low blood sugar. Also, stimulants such as coffee, chocolate, sugar, sweets, soft drinks, excess salt, spices and animal proteins may trigger seizures by suddenly changing the body’s metabolism. The Dewrito Pope is a false prophet. Extremely warm conditions are also a risk factor – you ignore your case of “swamp ass” at your own peril. Lack of sleep can change the brain’s patterns of electrical activity and can trigger seizures, so do not play tired.

There are over 40 different types of seizures, but they can generally be classified into 2 main types – Partial Seizures and Generalized Seizures. Visual stimuli like games can trigger both types. I’m going to outline the features of the most popular types of seizures so that you have an idea of what to look for, what to expect and what to do. None of this is meant to replace the advice of a professional. It’s simply to raise awareness.

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GENERALIZED SEIZURES

Generalized seizures occur when both hemispheres of the brain are affected. Generalized seizures can be preceded by an “aura. An aura may be emotional (e.g. fear, anxiety), physical (e.g. dizziness, nausea), or sensory (e.g. tingling or crawling sensation on the skin, spots or colours before the eyes, strange tastes or smells).

The most common forms of generalized seizures are:
A)tonic-clonic (convulsive) seizures and
B) absence seizures

A) tonic-clonic (aka convulsive) is the type which you may be most familiar with and easiest to recognize
The gamer loses consciousness right from the beginning of the seizure. Stay calm. This can last for 1-5 minutes – if it goes on for longer than this, call an ambulance. In fact you may want to call an ambulance anyway. Stiffened muscles cause a fall to the floor. This is not a problem. Clear away nearby objects that may cause injury when twitching and jerking of arms and legs begin. Eg clear away nearby furniture away. Do not restrain the gamer – let the twitching pass. They may bite down on the tongue and bleed – call ambulance. DO NOT put anything in the mouth for them to bite down on. You will cause damage to their teeth. Don’t worry, the tongue can be stitched afterwards. FOR THE LOVE OF GOD, do not put your finger in that mouth – you will lose it. When the seizure has ended, they will need to rest. Roll them on their side so that the saliva can drain out of the mouth. They may have soiled themselves in the process, so you can get a blanket to preserve their dignity. Do not cover them with the blanket until they can readily move (stand) on their own. Another seizure may occur soon after and the blanket can complicate things – embarrassment isn’t a life threatening condition.

B) absence seizures – Gamer loses consciousness but there are no convulsions with this type. No aura prior to event either. Gamer has a characteristic “blank stare” – you remember George Bush right? They may have repetitive movements are noted such as:
• chewing movements
• rapid breathing
• rhythmic blinking
• slight movements or tugging at clothing
The seizure only lasts a few seconds, and hence can be easily missed. After the seizure, the person has no memory of it. They are not confused and generally resume normal activity afterwards as if nothing happened. If someone “spaces out”, this could (COULD) be a seizure. At times they appear to be on autopilot and behave as if they do not hear you. Bring it to their attention or if you are really prepared, record it while it happens and ask them if they remember this afterwards. Do not upload to social media…unless it’s REALLY funny. No sense losing a friend over a mediocre joke.

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FOCAL SEIZURES

Focal (or partial) seizures - a smaller part of the brain is affected. The symptoms depend on exactly which part of the brain is affected. Vision, hearing or even movement can be affected. The most common forms of focal seizures are:

1) simple partial seizures (aka an “aura”). These can spread to become a complex partial seizure.

2) complex partial seizures

1) With a simple partial seizure, the gamer will not be unconscious, but they will not be able to control their body movements. They may be able to answer questions during the seizure and will remember everything after. They do not last long, and they do not always have convulsions. An onlooker may miss it if it happens. Comfort and reassure the gamer if (s)he feels confused following the seizure.

2) If the case of the complex partial seizure, the partial seizure activity has now spread to the rest of the brain. May become unconscious. No convulsions. They will no longer respond to questions.

They will have a blank look or empty stare. (S)he will appear unaware of the environment and may seem dazed
Inappropriate behaviours observed include:
• chewing movements
• uncoordinated activity
• meaningless bits of behaviour that appear random and clumsy including:
o picking at their clothes or trying to remove them
o walking about aimlessly
o picking up things
o mumbling.
Lasts about 2-4 minutes. After the seizure, there is usually a period of confusion lasting longer. No memory of event afterwards. Clear the area, do not restrain them if they start walking around unless absolutely necessary. Comfort gamer afterwards.

In general, seizures induced by videogames are more subtle that those evoked by similar visual stimuli. Uniquely, a lowering of the eyelids to a state of half-closed seems to be a presenting sign. http://www.ncbi.nlm.nih.gov...
If your child appears volatile, abnormally fatigued, and struggles to concentrate – keep an eye on them when they watch television and play games. These symptoms can often last for as long as a couple of days while the brain recovers. Difficulty in waking them from sleep can also be an indicator. Isolated seizures may not do much hard, but repeated seizures can have a negative effect on learning and development.

You can conduct your own experiment at home by limiting screen time and monitoring the behaviour response to that, but seeing a professional is always advised. An EEG (electroencephalogram) is the usual method used to make the diagnosis, but it is not always conclusive. The best way to test for abnormal brain response to video games is to play a video game during the EEG session. Definitive diagnosis is not my focus, so I won’t go any further on that.

It is a widespread practice in the industry to have games tested via software for seizure induction, but it’s by no means foolproof, and games do make it out that fail certain tests. It all depends on the software used for the testing. One example of such software is the Harding Flash and Pattern Analyser. Games such as MLB: The Show, Warcraft and Super Smash Brothers have failed various aspects of this test software according to one user at http://videogameseizures.wo... Also there are many flash based games that are available that may not have been subjected to any testing at all. If you play a lot of indie and flash games and are prone to seizures, you may find it useful to do some testing of your own. Safe Gaming everyone!

[mixelon]

This is a really neat article, good job posting something that can benefit all sorts of people.

I've never had seizures but I have half - fainted playing games before. But that's connected to other health issues. I sometimes get crazy motion sickness too, though very infrequently.

I wonder how many more people are going to start getting ill effects once VR takes of, simulation sickness is unpleasant.. I played halflife2 for a couple of hrs with the dk2 and felt like I was going to throw up. Most games are fine though. I would've thought field of vision spanning flashing lights and patterns would be a epilepsy nightmare.

[Octodad]

Thank you for reading. Never though about the OR stuff. An interesting point

[newflesh]

That's pretty deep

[stuna1]

Thanks for the informative article. As someone who has lived with seizures for over 2 decades, there is still very little information as to the warning signs, causes and most of care of a individual who sufferes from the debilitating effects of a full on body seizure typically known by physician's term as a Gran Mal seizure. A partial or less debilitating form of seizure is classified by physician is the Mini Mal seizure.

I personally have suffered from both versions, with Mini Mal being more common. As well as Mini Mal seizure's being the most common form among the general population of seizure sufferer. This is also why it is easy to mis-diagnose as well as easy to miss the warning signs, triggers and ultimately ways of combating, and preparing for the possibility of a re-occurrance.

So I thank you personally for sharing this information to those who have less understanding of the illness/syndrome, and also to inform those who might have experienced similar symptoms to at least have their physician check on them, even if just as a precaution.