Video gaming while driving: not a good idea!
Posted: 05/18/2013 Filed under: Gamers, Health Consequences, Legal Action | Tags: computer games, flash, flicker, photosensitive epilepsy, photosensitivity, seizures, video games Leave a comment »
After this photo was published in the UK’s Daily Record newspaper, the “reckless” driver who played a game while driving was identified and charged.
This week a motorist in Scotland was seen—and photographed—playing the video game Real Racing on his iPad while driving on a highway at 65 miles per hour.
In this country some states have laws that prohibit texting or phoning while driving. Most people realize that using any electronic device while driving is a distraction that impairs the driver’s judgment and attention, placing him/her plus any passengers, pedestrians, and nearby drivers at risk. It’s risky and unwise, and illegal in some places, but it’s a widespread practice nonetheless.
Gaming while driving is beyond reckless. Think of it: what if, in addition to the game creating a dangerous distraction, the images trigger a seizure in the driver? Even a brief seizure of a few seconds, especially at 65 mph, could lead to tragedy.
I tested lots of “footage” of Real Racing on the flash and pattern analyzer that determines whether digital image sequences fall within safety guidelines for photosensitive epilepsy. Although this particular game tested within the safety limits for luminosity/flash rate/pattern movement, many other games don’t. Maybe this driver only drives while playing games that pass the seizure safety test…and plays the rest at home.
Scottish police have brought charges against the 20-year-old suspect. “Motoring groups and politicians have condemned his antics,” according to the Daily Record. Read more…
Open letter to the BioShock creative team
Posted: 04/18/2013 Filed under: Photosensitive Seizure Prevention, Seizure Warnings, Video Game Companies | Tags: BioShock, computer games, flash, flicker, photosensitive epilepsy, seizure warning, seizures, video games Leave a comment »
Congratulations on last month’s successful launch of BioShock Infinite. The reviews are extraordinary. BioShock Infinite is said to set a new standard for what the video game experience can be. Players are moved and enthusiastic about many aspects of the game and speak effusively about their unprecedented degree of involvement with the story and characters. With all the creative energy, care, and respect for players that went into developing BioShock, though, the game–like so many others–exposes players to visuals that can cause seizures.
I examined several BioShock launch trailers and some other “footage” – a total of eight clips of a few minutes each – and assessed them using an application that identifies video sequences that can trigger seizures. Most of the material was fine, but three of the clips contained brief flashing sequences that don’t meet criteria for safe viewing. It doesn’t take more than a brief exposure to trigger seizures in those who are vulnerable.
This BioShock scene uses safe levels of flash.
Contrary to what many gamers assume, eliminating seizure triggers doesn’t make a game boring to look at or play. Irrational Software created a visually stunning, highly engaging experience in which most of the scenes don’t pose a seizure risk. Reports of video game-induced seizures began surfacing in 1981 in newspapers and medical journals. A great deal is known about what types of images and sequences can provoke seizures.
Guidelines for seizure-free video sequences were developed in the UK more than 20 years ago. Since 1991 all television programming and commercials there are required to pass a seizure-safety test. Japan put in place a similar measure following the 1997 Pokémon broadcast that led to hundreds of seizures. In 2005 the International Telecommunication Union published recommended universal guidelines for reducing photosensitive seizures from televised material.
While all these efforts were made to reduce the risk to consumers of photosensitive seizures, video game publishers took their own action—providing printed seizure warnings. The warnings began appearing in the early ‘90s, after a few consumers filed personal injury lawsuits. Putting a seizure warning on video games has thus far provided legal cover for your industry, but offers little protection for customers.
Flash in this scene is safe, too.
The warnings all state that photosensitive seizures happen to “a very small percentage of people.” Seizures from flashing images are not rare, but people believe they are because that’s what the warnings say! The wording of these warnings is based on researchers’ estimates that were made decades ago, before today’s sophisticated graphics and before more recent studies that suggest that many photosensitive seizures could be going completely unnoticed. Many doctors continue to think these seizures are rare because that’s what they were taught.
If you haven’t heard many reports of seizures happening while playing BioShock, don’t assume the seizures aren’t occurring. They’re just not being identified. A person experiencing seizures is likely to lose awareness and not even realize what’s happening, or notice that a bit of time has passed that they can’t account for. Furthermore, most seizures don’t involve convulsions, and the only sign others might see could be as subtle as a short period of staring.
Whether or not a seizure is noticeable, it’s a serious event with real risks to health. It can impair health, thinking, and behavior for days afterward. Sometimes a seizure results in permanent disability.
But this screen capture from the Harding Flash and Pattern Analyzer shows that flash in the BioShock sequence shown at upper left failed seizure safety guidelines.
It’s not reasonable to expect parents to continually monitor their kids for possible signs of a seizure, particularly given that video games are played while people face a screen. So let’s turn to older teens and adults in the midst of a game, who might theoretically be more self-aware and responsible for their own well-being. Will they be vigilant for seizure symptoms such as odd sensations or altered consciousness?
Just last month in a New York Times interview your creative director Ken Levine said, “We work really hard to wear down the audience’s ability to even process. If players are immersed enough, they stop treating it as a piece of artifice and just start experiencing it.” Do you see the problem here? In this ideal game experience, how can players be expected to “immediately stop playing and consult a doctor” as the warning advises, if they develop symptoms consistent with a seizure?
With BioShock Infinite now brought to market, people are asking what your company will do next. You could easily raise the bar further for the industry by publicly committing to developing seizure-safe games. I live in the Boston area and would welcome the chance to begin a conversation about this at your headquarters in Quincy.
Lawsuits filed after games caused seizures
Posted: 04/06/2013 Filed under: Legal Action, Seizure Warnings, Video Game Companies | Tags: American Academy of Pediatrics, computer games, Nintendo, photosensitive epilepsy, photosensitivity, product liability, seizure warning, Sony, Ubisoft, video games Leave a comment »
No consumer has won a product liability/personal injury case against a game manufacturer whose video game triggered seizures. Cases were either dismissed, settled, or won by the game company.
Despite their limited usefulness to consumers, seizure warning notices do seem to provide legal protection to game publishers. And juries have a hard time awarding damages to plaintiffs with a pre-existing condition, even if plaintiffs didn’t know of their photosensitive epilepsy prior to the seizure(s) triggered by a video game.
In one case Nintendo actually conceded that its game had in fact triggered seizures, but that didn’t get in the way of the company winning the case. A judge later overturned the jury’s verdict because Nintendo had withheld critical information in contempt of court.
The cases date back to 1991, but the apparent total number of cases–ten–is pretty small. One has to wonder what percentage of the seizures triggered by exposure to video games are ever identified as visually induced seizures.
One of the few consumers to reach a settlement is John Ledford of Alabama, whose settlement agreement bars John from discussing his own case. John has found another way to raise awareness of video game seizures. He has researched other cases and reached out to epilepsy organizations around the globe to raise their awareness of the continuing seizure hazard from video game images. John’s Facebook page contains most of the history I’ve assembled here:
| Year Filed | State | Plaintiff(s) | Game(s)/Platform/Defendant | Outcome |
| 1991 | MI | 15-year old Laura Moceri had grand mal seizure while playing. | Kid Icarus (Nintendo) | Lost |
| 1993 | IL | Chicago boy suffered occasional seizures during many hours of game play. | Nintendo | Dismissed |
| 1995 | AL | John Ledford had his first ever grand mal seizure while playing game at an arcade. The seizure damaged his optic nerve and caused blindness in one eye. | King of the Monsters II (SNK Corp.) | Settled |
| 1998 | LA | 13 year-old Joey Roccaforte had clusters of violent seizures | Mega Man X (Super Nintendo) | Jury ruled for Nintendo; judge later vacated the decision because Nintendo withheld critical information before and during trial. |
| 2001 | LA | Esther Walker, mother of 30-year old Benjamin Walker, who died from hitting his head on a table and sustaining internal injuries during a game-induced seizure. | Nintendo 64 | Lost |
| 2001 | LA | 11 year-old Michael Martin, son of Eric Martin, mayor of St. Martinsville, LA. Seizures that began happening during games began occurring also during sleep. | Super Mario Kart (Nintendo 64) | Settled personal injury claim; lost case advocating better warnings. |
| 2001 | LA | 6 year –old Kynan Hebert, son of Lynette Benoit | Nintendo | Dismissed |
| 2002 | FL | 16 year-old Dominic Zummo | Star Wars Episode I: Jedi Power Battles (LucasArts Entertainment, SONY) | Unknown |
| 2007 | NY | While watching his brother play a game, 4 year-old boy had a seizure causing permanent injury. | Spyro: Enter the Dragonfly (Vivendi, SONY Playstation 2) | Last available information: attorney for plaintiff was seeking other plaintiffs for class action suit |
| 2011 | CA | Navy F-18 pilot John Ryan McLaughlin injured in a grand mal seizure that causes permanent loss of flight status | Oblivion: The Elder Scrolls IV (Bethesda Software), Sony Playstation 3. | Still pending; no other information available. |
What constitutes product liability?
In 1997 the criteria for product manufacturer’s liability for a product that has caused harm were revised by the American Law Institute, an independent body of legal experts that drafts and publishes restatements of common law in order to clarify and simplify it. Its work is used as a resource by state lawmakers, judges, and lawyers. Every state has its own laws concerning burden of proof, the awarding of damages, and the like.
The 1997 restatement of product liability law states, ”a product is defective when, at the time of sale or distribution, it contains a manufacturing defect, is defective in design or is defective because of inadequate instructions or warnings.” These conditions are then defined separately:
- A product “contains a manufacturing defect when the product departs from its intended design even though all possible care was exercised in the preparation and marketing of the product.”
- A product “contains a design defect when the foreseeable risks of harm posed by the product could have been reduced or avoided by the adoption of a reasonable alternative design by the seller or other distributor, or a predecessor in the commercial chain of distribution, and the omission of the reasonable alternative design renders the product not reasonably safe.”
- A product “is defective because of inadequate instructions or warnings when the foreseeable risks of harm posed by the product could have been reduced or avoided by the provision of reasonable instructions or warnings by the seller or other distributor, or a predecessor in the commercial chain of distribution and the omission of the instructions or warnings renders the product not reasonably safe.”
Some game companies are apparently working to make games that do not provoke seizures, but only Ubisoft has made a public commitment. Most are merely reworking their warnings. More on the problem with warnings in a forthcoming post.
DVDs for genius babies may flunk safety test
Posted: 03/04/2013 Filed under: Home Video/DVD | Tags: Baby Einstein, baby videos, Brainy Baby, flash, flicker, photosensitive epilepsy, photosensitivity Leave a comment »
Whether or not DVDs marketed to stimulate educational development in babies and toddlers provide a headstart on learning, their visual content may be provoking seizures in viewers. When I tested a number of the Baby Einstein and Brainy Baby DVDs, I found some sequences of patterns and flickering that could easily provoke seizures in someone with photosensitive epilepsy.
The Harding Flash and Pattern Analyzer found no violations of seizure safety guidelines in most of the DVDs I tested, and those containing violations were not full of seizure-provoking sequences. For anyone vulnerable to visually induced seizures, though, the offending sequences are very clearly quite unsafe to watch. Even brief sequences of a few seconds of flickering images can trigger seizures in some people, even if they have no history of seizures. A soothing DVD for babies isn’t where you’d expect to be bombarded by images that in some people cannot be viewed without triggering a seizure.
The spinning pinwheel in Baby Beethoven
Flicker doesn’t always look like a light pulsing on and off. The pattern and flicker sequences in these DVDs that failed to meet criteria for seizure safety included screen-filling images of a swirling black and white spiral, a rotating pinwheel, interlocking gears in motion, and “snow” in motion that looks like a TV signal problem. The rotating pinwheel has small gaps between the colors so that when the pinwheel spins, in effect the colors and white areas create a flicker.
To be clear, photosensitivity has never been found in children under age 2, and it typically doesn’t emerge until age 6 or 7. The brains of babies may not have developed to the point where viewing these images might actually provoke a seizure. But who’s to say these images might can’t create some form of neurological stress in very young children? Then, of course, there is a seizure risk to any photosensitive parents, siblings, caregivers, and others who might be watching alongside the baby.
This whirling spiral takes up the entire screen for 5 seconds during Brainy Baby Left Brain. Even a small still image is hard to look at!
In addition, researchers have raised the possibility that one factor influencing the emergence of photosensitive epilepsy in an individual is that person’s cumulative exposures to visual stimuli. The theory is that each time the brain processes these intense visual experiences, its capacity to absorb more of them is reduced a little. Add all of those incidents up, and the brain eventually uses up its lifetime ability to normally absorb any more of these experiences. From that point onward, vivid patterns and flashing lights and images can provoke seizures.
Note that home videos are not subject to photosensitive seizure regulation in any country. The UK and Japan enforce seizure safety standards on broadcast TV, and the UK also provides at least a warning for movie theater audiences. New standards going through the approval process at the International Organization for Standardization (ISO) will eventually cover all image presentations, including interactive images.
In Baby van Gogh these gears spin for 12 seconds, a risk for anyone with pattern sensitivity
With thanks to Michael Rich, MD, MPH, Director of the Center on Media and Child Health at Children’s Hospital Boston for first bringing to my attention the spiral image above.
Nintendo knew about, downplayed seizure risks: BBC report
Posted: 02/20/2013 Filed under: Legal Action, Seizure Risk, Seizure Warnings, Video Game Companies | Tags: computer games, flash, flicker, Nintendo, photosensitive epilepsy, seizures, video games 1 Comment »
Nintendo’s Mega Man X was one of the four games tested by the BBC for this investigative report that did not meet British TV seizure safety guidelines.
A BBC report on Nintendo revealed that the company knew more than 20 years ago which of its games were most likely to cause seizures–and downplayed the seizure risk to customers. A former Nintendo customer relations employee interviewed for the story said that many customers called to complain about experiencing seizures. Because he wanted to advise customers concerned about the seizure risk, he asked the company’s R & D group for a list of the games most likely to cause seizures.
Developers came up with a list of more than 30 games. Before the list was released to customers, he said, the company’s lawyers pared down the list to 12 – 15 titles. As customer complaints about seizures grew, Nintendo stopped releasing any seizure information about specific games. The Nintendo executive interviewed asserted that the company began making its games safer and started including seizure warnings with game instructions as soon as the problem came to their attention—in 1991.
The story, featured on the BBC’s Outrageous Fortune program in 2004, also includes an interview with photosensitive epilepsy expert Prof. Graham Harding. Using his own flash and pattern analyzer Prof. Harding shows the results of testing some Nintendo games for seizure safety.
To view the ten-minute segment about video game seizures in the report on Nintendo, first go to www.youtube.com/watch?v=0aFhW56c2Vg and fast forward to about 5:15 into the clip. The seizure segment continues at the beginning of this clip.
The documentary was never aired in the US, and I’d long since given up searching for it online. But I recently came upon it thanks to John Ledford, who has been tracking seizure lawsuits filed against the game industry. John became blind in one eye as a result of his first grand mal seizure—which occurred while he was playing a video game in 1994.
Today the sound, tomorrow the picture?
Posted: 01/20/2013 Filed under: Photosensitive Seizure Prevention, Political Action & Advocacy, TV, Video Game Companies | Tags: computer games, International Telecommunication Union, photosensitive epilepsy, photosensitivity, seizure prevention, Sony, video games 4 Comments »
Have you noticed that watching TV is less annoying lately? Commercials are now required to be no louder than the programming surrounding them. On December 13 an FCC regulation went into effect that was designed for just that. The CALM Act, approved by Congress in 2010, directed the Federal Communications Commission to make it possible to watch TV without constantly turning down the volume of advertisements.
Since the introduction of television in the 1950s, many consumers have complained to the FCC about the loudness of commercials. What prevented the FCC from doing anything in response was that the issue was technically complicated. Multiple factors can contribute to the perceived loudness of a broadcast, including the strength of the electrical signal, the degree to which the sound signal is compressed. In addition, there was no standard method for content creators and broadcasters to measure broadcast volume.
In 2006, the International Telecommunication Union–the same UN-affiliated standards body that has published specifications for protecting TV viewers from photosensitive seizures–proposed a new technique for measuring broadcast volume that allows uniform evaluation across national boundaries. In addition, the ITU proposed a numerical “target loudness” using the new loudness gauge. Thanks to the ITU, it became possible to define, comply with, and enforce limits on loudness.
Four years later the United States Congress passed the CALM Act with little debate, by unanimous vote in the Senate and by a voice vote in the House. California Congresswoman Anna Eshoo, who introduced the bill, said it was by far the most popular bill she’d ever sponsored. She said the bill “gives consumers peace of mind, because it puts them in control of the sound in their homes.” She was quoted saying, ”If I’d saved 50 million children from some malady, people would not have the interest that they have in this.” By that time the UK, France, Norway, Italy, Japan, Brazil, Israel, Germany, Austria, Switzerland, Poland, and the Netherlands were already limiting the loudness of commercials or had begun action on the issue.
These days even the video game industry is paying attention to some kind of audio standards, if only for consistency across products. According to an July 2012 interview in Designing Sound, Sony Computer Entertainment Europe is looking at smoothing out the volume among their own game titles.
Unfortunately, in this country making TV safer to watch for the visually sensitive–or making video games safer to play–isn’t on the legislative agenda. Consumers and policy makers aren’t aware of the need. The technical groundwork is already in place for regulations to prevent screen-induced photosensitive seizures, thanks to ITU specifications (and similar versions developed by the UK and Japan), and to similar guidelines adopted by the World Wide Web Consortium for web-based content.
Here’s where things stand at the moment in making US electronic screens safe for those with photosensitive epilepsy: Photosensitive epilepsy protection standards now apply to all federal agency websites. The Photosensitive Epilepsy Analysis Tool (PEAT) downloadable from the PACE Center at the University of Wisconsin at Madison makes available to website designers and software developers a free tool that tests screen content for compliance with seizure safety guidelines. The tool is not intended for entertainment industry developers, however; these companies need to buy commercially available assessment tools.
I’ve written previously about some of the complexities of bringing new screen safety standards to the American telecommunications industry. I”m going to learn more about the legislative process in coming months. My State Representative filed a bill last week to create a commission to study the issue of video game safety for minors at home and in school here in Massachusetts. It will take considerable time to even bring the bill to a public hearing, but as I’ve recently learned, all bills filed in the Massachusetts legislature receive a public hearing at some point in the two-year session. The two years just began this month. Stay tuned.
Top First-Person Shooters Fail Safety Test
Posted: 12/17/2012 Filed under: Photosensitive Seizure Prevention, Seizure Risk | Tags: Call of Duty Black Ops 2, computer games, first-person shooter, Halo 4, Medal of Honor: Warfighter, photosensitive epilepsy, photosensitivity, seizures, video games 2 Comments »
A while back, I looked at some MMORPGs (massive, multi-player, online role-playing games) and found that they typically don’t pose a high risk of triggering photosensitive seizures. Their appeal lies in the social world of collaborative missions, the acquisition of skills and material goods, and immersion in a detailed narrative.
First-person shooter (FPS) games are a different story, you might say. They offer continuous combat with lots of vivid, brightly flickering sequences, a scenario that is much more likely to bring on visually induced seizures. Because players watch from the shooter’s up-close perspective, the flashes from explosions brightly illuminate much of the entire screen. When more of the field of vision is exposed to flashes, more neurons are activated for visual processing, raising the seizure risk. Lots of quick scene cuts are typical while the shooter races and maneuvers through territory at top speed. In addition, the rapid fire of high-caliber weapons causes shaking and vibrating of the scene that adds to players’ visual processing load.
I don’t offer an opinion about the content, value, message, or age- appropriateness of video games. My purpose is to provide information on their potential to induce photosensitive seizures in people who may have this genetic vulnerability. But I will confess that I turned my attention to FPS games after the recent news that that Navy SEALS had shared classified information with the developer of Medal of Honor: Warfighter. I was curious as to whether the game was also likely to provoke seizures. In fact Warfighter does fail the test for seizure safety, and it also received poor reviews and didn’t sell well.
My testing showed that two blockbusters in this game genre, Halo 4 ($ 220 million in sales on launch day) and Call of Duty Black Ops 2 ($ 500 million during its first 24 hours), released last month, violate international guidelines for preventing photosensitive seizures. Given their huge popularity and the high ranking of many FPS games on reviewers’ best-of-the-year lists, it seemed like an appropriate time to look at the seizure safety of FPS games as a category.
I tested the 14 games on GameSpot’s list of the most popular FPS games (which includes all gaming platforms). To obtain representative scenes from each game, I downloaded official trailers and user-submitted video from YouTube. Most were less than 5 minutes long. If the first clips I tested for a game didn’t fail the safety test, I tested several more clips for each game, since it was possible that failing sequences weren’t included in a particular clip. In all I tested several dozen video segments on the Harding Flash and Pattern Analyzer.
As shown in the table below, the visuals in every game either exceeded the limits for photosensitive seizure safety or came close to the limits, a result that received a “Caution” grade from the analyzer software. Note that any game that didn’t actually fail cannot be deemed seizure-safe, since it could easily have unsafe sequences I didn’t locate.
FPS games from GameSpot’s “best games by popularity” list
The Caution designation by the analyzer software recognizes that every individual’s vulnerability to seizures changes in response to internal factors (such as fatigue, illness, alcohol, menstrual cycle, stress) and environmental conditions (proximity to/size of screen, screen brightness, duration of play). The risk of seizures for any individual using the same game on different occasions varies depending on these circumstances.
So caution when playing shooter games is certainly appropriate. Take breaks, don’t play when sleep-deprived, and don’t sit too close to the screen. A game that’s never triggered seizures before may trigger a seizure another time, even in people who’ve never had a seizure in their lives because photosensitivity is a latent trait until it is activated. Sometimes seizures are so subtle people may not realize they are happening, but even small seizures can affect mental and physical functioning for a day or two.
A game with two new champions
Posted: 11/27/2012 Filed under: Uncategorized | Tags: epilepsy advocacy, Epilepsy Foundation, Jerry Kill, Norwood Teague, University of Minnesota Gophers Leave a comment »
University of Minnesota Golden Gophers, coached by Jerry Kill, play Big Ten football at the Minneapolis TCF Bank Stadium
In today’s post I’m departing from my usual focus on video games as a seizure trigger. With National Epilepsy Awareness Month coming to a close, it’s seizures in the context of the real-world game of football that recently caught my attention.
No one has done more this month than University of Minnesota football coach Jerry Kill and his athletic director Norwood Teague to educate the public about seizure disorders.
The coach had a seizure last weekend during a game against Michigan State. It was his second game-time seizure in as many months, and his third in two seasons at Minnesota. He has needed to leave the game when they happen, and in the first two instances he was admitted to a hospital. On Saturday he rested and went home to recuperate. The seizures, which Kill has experienced for years, have become more frequent, and the stresses during a game are probably adding to his seizure vulnerability. He was back at work on Monday.
The Epilepsy Foundation should publicly recognize Kill and Teague with some kind of award for doing the right thing: doing what’s necessary to carry on, taking preventive measures, and not making too big a deal about it. The players have been publicly very supportive as well.
Teague said at a post-game news conference: ”I know this will bring up questions about him and moving forward, but we have 100 percent confidence in Jerry…He’s as healthy as a horse, as they say. It’s just an epileptic situation, or a seizure situation, that he deals with. He has to continue to monitor all the simple things in life, like we all do — you watch your diet, watch your weight, watch your stress, watch your rest. He just has to watch those things…You don’t want to downplay it, but you get to the point where you realize it’s just something he has to deal with at times. You don’t want to say it’s not a big deal, but in a way, it’s easy to deal with in a lot of ways.”
Yesterday Teague added that he will be looking to offload some of his coach’s responsibilities until Kill’s medical condition stabilizes. He stated this in a very positive way. “Is there doubt now about him moving forward? Absolutely not…We have to do a better job here of managing around him…I have to do a better job of helping him. I can take some things off his plate that other coaches can do.”
Kill’s condition and the way he and his management have handled it provide valuable lessons about seizure disorders. For starters, most people who have seizures:
- Are regular folks, able to live pretty normal lives during seizure-free stretches
- Aren’t unusual. About one percent of the population has epilepsy
- Aren’t looking for special treatment but may benefit from reducing stress during periods of increased seizure activity
- Can’t predict the next seizure, although certain situations–both internal and external–are triggers. (Some people experience auras beforehand.)
- Do not experience a medical emergency while seizing
- Require rest and can’t function properly for at least several hours after an episode
There’s no way to tie my thoughts on this directly back to video games and seizures. It just needed to be said.
Bread and video games
Posted: 11/08/2012 Filed under: Diagnostic Challenges, Health Consequences, Medical Research | Tags: celiac, computer games, EEG, flash, gluten intolerance, photic stimulation, photosensitive epilepsy, photosensitivity, seizures 1 Comment »
What do a loaf of bread and an action video game have in common? Both are man-made and widely consumed, yet hugely underrecognized as potentially serious health hazards. There are a lot more parallels.
Sensitivity to gluten, the primary protein in wheat, and to the bright flash and rapidly moving patterns game of screens, are both considerably more pervasive than the medical community and the general public had realized. Awareness of gluten sensitivity has grown tremendously in the past decade, though, because a portion of the medical community broadened its understanding of a disorder once defined by very rigid diagnostic criteria.
Consider this comparison:
Progress on the gluten front
For decades the only type of gluten sensitivity recognized by doctors was celiac disease, a severe condition that often, but not always, manifests with gastrointestinal problems. The only diagnostic testing required an intestinal biopsy that–turns out–is easily falsely negative. After a negative biopsy, would be told that celiac disease had been ruled out, and that therefore it was OK to eat wheat and other grains containing gluten. In actuality many of these patients either had celiac–but a misleading biopsy that didn’t collect tissue samples from the affected area of the intestine–or they had a different form of gluten sensitivity that causes damage only to other body organs, rather than the intestine.
Because doctors were taught in medical school that celiac disease is very rare, occurring in only one in several thousand individuals, there seemed to be little reason to consider the diagnosis in patients, order a biopsy, or question a negative biopsy result. Some researchers suggest that ten percent or more of the American public has a sensitivity to gluten, in most cases with no obvious symptoms or symptoms that don’t suggest a food sensitivity. Even without obvious symptoms gluten intolerance can be a very serious disorder that affects daily functioning and quality of life.
Growing numbers of consumers without an official diagnosis of gluten sensitivity are being more proactive by experimenting on their own with a gluten-free diet as a healthier way to eat. Many notice a range of improvements in their well-being from this change. A rapidly expanding market of prepared gluten-free foods makes a gluten-free lifestyle less burdensome. An increasing number of restaurants offer gluten-free menus, and new gluten-free foods are a booming market for food retailers. Celiac and gluten-free support groups provide practical and moral support. In addition to peer-reviewed research, there are now a lot of books for consumers and online resources. Probably most consumers are learning about gluten sensitivity from these sources rather than their clinicians, and some are helping educate their doctors about it.
The photosensitive epilepsy front
Because doctors were taught in medical school that photosensitive epilepsy is very rare, occurring in only one in several thousand individuals, there has seemed to be little reason to consider the diagnosis in patients, order an EEG with photic stimulation, or question a negative or inconclusive EEG. There is no practical, reliable way to know how prevalent photosensitive epilepsy is in the general population. Even without obvious symptoms of a seizure, people who experience subtle seizures can experience impairments that affect daily functioning and quality of life.
Without an official diagnosis of photosensitivity, consumers can experiment with a screen-reduced or screen-free lifestyle–should they have an inkling that subtle seizure activity caused by screen exposure is affecting their health. However, at this time there are few products or supports to help them cut back on recreational screen time. A limited number of mental health providers offer therapy for Internet or video game addiction. Most focus on treating the addiction itself rather than on overcoming the physical and mental health consequences of exposure to potentially seizure-causing screens. Consumers are still essentially on their own to figure out the connection between video games and seizure activity, and there is little for them to read on the subject. Little research is being carried out in the US on photosensitivity and today’s electronic entertainment.
Perhaps there is reason to be encouraged by the progress in educating the public and clinicians about gluten-related health problems. In the face of similar obstacles to wider awareness and prevention, it should be possible for seizures induced by visually overstimulating electronic media to become better known, understood, and prevented. In the interim, a great deal of work lies ahead to empower consumers with the information they deserve about screen-induced seizures. Please help spread the word.
7 seizure triggers per hour from Spanish TV
Posted: 10/21/2012 Filed under: Medical Research, Political Action & Advocacy, TV | Tags: photosensitive epilepsy, photosensitivity, seizure prevention, TV Leave a comment »
Jaime Parra, MD, PhD, with poster describing the Spanish television study
Spanish TV viewers are exposed to potentially seizure-inducing visual sequences about seven times per hour, according to a study released this month at the 10th European Congress on Epileptology in London. The study was led by Jaime Parra, MD, PhD, an epilepsy specialist at Madrid’s Hospital La Zarzuela and Sanatorio Nuestra Señora del Rosario.
Dr. Parra and his team recorded 105 hours of broadcasts across seven channels, capturing four consecutive hours of morning programs on five consecutive days in January. A total of 738 instances were identified where viewers were exposed to visuals that did not meet the safety guidelines for visually induced seizures. The Harding Flash and Pattern Analyzer assessed flash rate, luminance (brightness), intensity of red images, and spatial patterns.
Of the 738 safety violations, 714 incidents involved bright flash. The study’s authors concluded that “Spanish broadcasters seem to be unaware of the risk of photosensitive epilepsy. National guidelines should be adopted to lower the risk of Spanish TV content triggering epileptic seizures in susceptible individuals.” The safest channel was dedicated to children’s programming. The investigators plan to bring their results to the attention of Spanish media and government officials as well as the Spanish public.
Results from the next stage of this project, which will involve analyzing the intensity of the visual stimuli that were recorded, will be presented at an upcoming meeting of the Spanish Neurological Society. The team also plans to assess television broadcasts in other European countries.
To read the poster summarizing the initial findings, click here.
