Visually-provoked seizures: Consensus of the Epilepsy Foundation Working Group

Area of Science:

• Neurology and Public Health
• Epilepsy Research and Management

Background:

• Previous 2005 consensus guidelines on visually-provoked seizures (VPS) need updating due to advancements in technology and scientific understanding.
• Visually-provoked seizures (photosensitive epilepsy) remain a significant concern for individuals with epilepsy and a public health issue.

Purpose of the Study:

• To update and expand consensus guidelines for minimizing risks associated with visually-provoked seizures (VPS).
• To provide specific recommendations for various stakeholders including patients, families, clinicians, media designers, architects, and regulatory agencies.

Main Methods:

• Convened an international expert panel to collate existing literature, information, and expert opinions on VPS.
• Developed consensus guidelines based on collated information, without conducting a formal systematic review.
• Guidelines address patient education, clinical assessment (including EEG and MRI utility), and specific visual stimulus parameters to avoid.

Main Results:

• Provides tailored advice for patients on symptoms, medications, and behavioral modifications.
• Offers guidance for clinicians on assessing seizure events and identifying triggers using history and EEG.
• Specifies visual stimulus characteristics (e.g., 10-20 Hz flashing patterns, ~1-8 cycles/degree stripes) to be avoided by media and environment designers.

Conclusions:

• Updated guidelines offer a comprehensive approach to managing and preventing visually-provoked seizures.
• Emphasizes the need for awareness and proactive measures from individuals, healthcare providers, and content creators.
• Highlights VPS as an individual and public health problem, encouraging continued research and risk-reduction efforts.