Fifteen patients, ages 9 to 15 years, who experienced epileptic seizures while playing video games are reported from St Thomas’s Hospital, London, UK. An additional 20 patients in 12 reports in the literature are reviewed, and 3 further patients are described in an addendum. The majority had the first seizure as a result of the video game. Seizure patterns were generalized tonic clonic in two thirds; some had absence and 30% had juvenile myoclonic epilepsy. Photosensitivity occurred in 70%, while excitement, fatigue, sleep deprivation, and cognitive processing were important precipitants in others. Partial, mainly occipital, seizures occurred in 29%. Management was individualized, and AEDs were not always necessary. 
COMMENT. Video game seizures are reflex epilepsies, generalized or partial, and a feature of various idiopathic epileptic syndromes. Both photic and non-photic precipitants are involved. The avoidance of the precipitant may prevent the progression of minor absences, jerks, or visual phenomena to a generalized tonic clonic epilepsy.
See Ped Neur Briefs April 1994, p 28, for a previous report of 10 patients seen at the University of Washington, Seattle, and a review of 20 cases cited in the literature. The comment that video game related seizures are more common than previously recognized appears to be confirmed.