The effect of video-game software in video-game epilepsy

The individual role of video-game (VG) programs in VG activation is still unclear. Strict relations between VG seizures and photo- and pattern sensitivity suggest that programs per se may have a role in seizure activation.

We tested a series of 12 commercially available VG programs in 30 subjects aged 7-28 years; test protocol comprised intermittent photic stimulation (IPS), pattern stimulation, and a game session with 12 programs, each played for 5 min, delivered from a 50-Hz screen.

Activation was observed in 17 subjects; marked differences were observed between different games: two programs activated 13 subjects; one program did not provoke activation. High variability between scenes makes it impossible to define mean brightness for the whole program. Activation correlated with "steady maximal brightness" (SMB) within a program; SMB is defined as the brightness in lux of the brightest scene steadily present in a program. SMB varied between 6 and 305 lux in tested programs. Difference in activation between different games was statistically significant (p < 0.001). Pattern sensitivity is strictly correlated with the probability of VG activation (p < 0.001).

Our study demonstrates a strong variation in activation between different game programs and a strict relation between VG activation and pattern sensitivity. Programs with SMB >100 lux should be regarded as potentially dangerous: programs with SMB <50 lux may be considered relatively safe.