Visually-evoked pattern and photomyoclonic responses in video game and television epilepsy: case reports

This research paper reports a case study of two male photosensitive epileptic patients, aged 14 and 16 years old respectively, whose epileptic seizures were often triggered by the flickers from television and video games respectively. The 14-year old patient had no family history of epilepsy, while the 16 year old had a family history of epilepsy. A comprehensive electroencephalogram (EEG), including hyperventilation, intermittent photic stimulation (IPS) and pattern stimulation were carried out on them and EEG abnormalities including photoparoxysmal responses (PPR) and generalized myoclonic responses were evoked. A thorough analysis of the EEG morphology of the myclonic responses and the clinical manifestations showed evidence of two separate entitles of seizures namely: visually evoked pattern-myoclonic responses (PTMR) and visually evoked photomyoclonic responses (PMR). PTMR was independent of flash rate and occurred before a PPR and at the same time as the flash rate, while PMR occurred after the PPR and was dependent on flash rate. These findings suggest that "Video Game" epilepsy is probably a pattern sensitive epilepsy, electronic screen being the source of the triggering patterns; hence, the morphology and the family histories and the myoclonic phenomena differ from those of pure photosensitive epilepsy.