Photosensitivity and pattern sensitivity were evaluated in 67 reactive epileptic children, aged 4-19 years, at Universita “La Sapienza,” Rome, Italy. Fifty-one percent showed sensitivity to both light and pattern, 33% showed photosensitivity, and 16% were pattern sensitive. Pattern sensitive patients without photosensitivity had a higher incidence of focal symptomatic epilepsies, neurologic abnormalities, and focal EEGs. The EEG in pattern sensitive children showed focal polyspikes, spikes, slow or sharp waves in occipital regions, whereas photosensitive patients had more frequent generalized polyspike-wave and spike-wave complexes in the EEG. [1]

COMMENT. Patients with pattern sensitivity are at risk of focal, symptomatic seizures and neurologic abnormalities, whereas those with photosensitivity have generalized seizure patterns.

Video-game epilepsy. Kasteleijn-Nolst Trenite DGA, of the Instituut voor Epilepsiebestrijding, Heemstede, the Netherlands, comments on video-game epilepsy [2]. 50 cases have been published world wide. Mean age is 13 years, and 75% are male. One-third had a prior spontaneous or visually induced non-video-game seizure, and 50% showed epileptiform EEG discharges with photic stimulation.

Only 5% of epileptic patients in general are sensitive to photic stimulation. The video game is a specific provocative factor in predisposed “photosensitive” epileptic patients. These patients are also sensitive to television (40%), flickering sunlight (35%), disco lights (25%), and striped patterns such as Venetian blinds and escalators (10%). In video game epilepsy, precipitating factors might include color, flashing lights or patterns, the cognitive content, and lack of sleep. Studies in the Netherlands show that viewing a “flashing” program on a 50 Hz television in close proximity to the set is the most provocative stimulus. A video game is more provocative than a picture with less color and movement. Children should be kept at a distance of at least 2 m from a television screen. (see Ped Neur Briefs Sept 1994).