Photosensitive epilepsy

Video games warn of setting off seizures

Players with photosensitive epilepsy may be affected by bright flashes

By BEN FINLEY Knight Ridder News Service

Thursday, December 26, 2002

Washington -- The millions of video games sold in the United States this holiday season come with warnings that sometimes are overlooked. They say that the games can trigger seizures in some players, especially children, who have a rare condition known as photosensitive epilepsy.

For these people -- perhaps 1 in 4,000 -- a video game's bright flashes and dramatic patterns sometimes can set off an electrical storm of brain signals. The storm in the brain may cause involuntary body movements, involuntary oral or visual responses and blackouts, according to Edward Novotny, director of the Pediatric Epilepsy Program at the Yale University School of Medicine in New Haven, Conn.

The video game industry does not dispute the possibility. Rather, it stresses that its products do not cause the attacks; at most they trigger them in susceptible people under certain unusual conditions. Pediatric epilepsy experts generally agree, and note, as the industry does, that strobe lights and flickering TVs sometimes can have the same effect.

Some video game players, whether or not they have photosensitive epilepsy, may suffer lesser symptoms such as nausea, eye or muscle twitching, loss of awareness, involuntary movements or altered vision, reported Yukitoshi Takahashi, head of pediatrics at Japan's Gifu University School of Medicine.

Lawsuits against game-makers

Asked about the phenomenon of seizures, the game-makers' Washington-based trade association, the Interactive Digital Software Association, provided a prepared statement. It says: "Although photosensitive epilepsy is not caused by the visual media, as a service to consumers, game system and individual game instruction manuals prominently feature epilepsy warnings that are included when each game system and individual software is sold in the United States."

The statement concluded that "due to pending litigation we cannot comment further at this time."

Nintendo of American, based in Redmond, Wash., whose products are in 40 million U.S. homes, is the defendant in two pending Louisiana lawsuits. They allege that the industry's most famous game-maker skimped on design, testing and warnings for products that are "inherently and unreasonably dangerous."

Nintendo responded in a prepared statement that "consumers' health and safety has always been a priority" and noted that it has provided seizure warnings on its products since 1991. Acknowledging the Louisiana suits, the company said it had faced suits before, and "none of the cases has resulted in a decision against Nintendo."

A similar suit is under way in Tampa, Fla., against Sony Computer Entertainment America Inc., the biggest U.S. game-system maker, and LucasArts Entertainment Co. LLC, maker of a "Star Wars" game that allegedly triggered seizures in a Tampa boy.

Tom Sarris, a LucasArts spokesman, said the company did not comment on pending lawsuits. Sony also declined comment.

Adequacy of warnings

The pending lawsuits, which are looking into how game-makers responded to the seizure problem, eventually may clarify the risks manufacturers perceived in current and older versions of their games. In the meantime, most debate has been about the adequacy of warnings and the number of players affected.

By most estimates, 3% to 5% of all people who have epilepsy in the United States, which is about 1% of the population, can suffer seizures when exposed to bright flickering light. That comes to 84,000 to 140,000 Americans. The number of them who ever experience seizures while playing video games, is far smaller.

Lawyer Elizabeth Dougherty of Metairie, La., who represents three Louisiana plaintiffs in suits against Nintendo, said the company had turned over to her 450 complaints of full-blown seizures among Nintendo players, dating back as far as 1989.

She said she received from Nintendo 4,400 pages of complaints from players who said they experienced lesser symptoms, such as nausea or altered vision. She estimated their number at 1,200 or more.

Neurologists who specialize in photosensitive epilepsy say children ages 7 to 19, especially children at puberty, are most susceptible. About 145 million Americans play computer or video games, and roughly half of all Nintendo, PlayStation and Xbox game players are younger than 18, according to the Interactive Digital Software Association.

A Catch-22 makes protecting vulnerable players especially difficult, said Graham Harding, a neurophysiologist at Aston University in Birmingham, England, who specializes in photosensitive epilepsy.

While Nintendo, for example, warns that anyone who has had a seizure induced by flashing lights or patterns should consult a doctor before playing a video game, Harding said, that doesn't protect against a first attack.

"Warnings are good except for people who don't know they are photosensitive," Harding said.

TIPS FOR PLAYERS

Here's what experts recommend for people who play video games:

-- Take a 15-minute break every hour.

-- Do not play when fatigued.

-- Play as far as possible from the screen. Six feet is recommended.

-- Keep the room's lights on when playing.

-- Don't play video games if seizures are in your personal or family medical history, unless you've consulted your doctor.

-- Bleary eyes, twitching and distractedness are signs it's time to stop.

-- High-definition television screens are better than low- definition screens. Small screens are better than big ones.

Source: Knight Ridder News Service

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