Visually sensitive seizures: An updated review by the Epilepsy Foundation

Area of Science:

• Neurology
• Epileptology
• Neurophysiology

Background:

• Photosensitive seizures (PS) are provoked by visual stimuli, affecting up to 1 in 4000 individuals, with potentially higher prevalence.
• The proliferation of digital media, virtual reality, and 3D content necessitates an updated review of light-induced seizures.
• Photosensitivity is more common in younger individuals and specific generalized epilepsy forms, and can coexist with spontaneous seizures.

Purpose of the Study:

• To provide an updated literature summary on photosensitive seizures (PS) and the photoparoxysmal response (PPR).
• To review the mechanisms, presentations, and risk factors associated with visually-induced seizures.
• To discuss prevention strategies and the role of scientific and regulatory efforts.

Main Methods:

• A nonsystematic literature review was conducted using PubMed.
• Search terms included "photosensitive" and "epilepsy."
• The review synthesized findings on the photoparoxysmal response (PPR) and photosensitive seizures (PS).

Main Results:

• Photosensitive seizures (PS) are linked to genetic factors and abnormal white matter connectivity, with hyperexcitability in the occipital cortex.
• Specific visual stimuli, including flashes brighter than 20 candelas/m² at 15-20 Hz, red flashes, and oscillating stripes, pose a risk.
• Virtual reality and 3D content are generally benign unless containing specific provocative elements like flashes.

Conclusions:

• Visually-induced seizures remain a significant public health concern.
• Prevention strategies include stimulus avoidance, protective eyewear, and medication.
• Ongoing scientific, regulatory, and public education efforts are warranted to mitigate risks associated with photosensitive epilepsy.