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:
|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.”
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Another flashy music video on YouTube, and this one’s been viewed hundreds of millions of times since its July launch. The viral phenomenon “Gangnam Style” by Korean pop star PSY has lots of flash, but surprisingly, only one instance of exceeding seizure safety guidelines.
In the problem sequence, images of PSY rapidly alternate with images of another Korean performer, Kim Hyun-a. Alternating between the bright, contrasting images at a rate of 3 times per second or more creates a flash effect capable of inducing a seizure.
The wildly popular“Gangnam Style” video was followed several weeks later by the release of a female version,“Oppa Is Just My Style,” that includes more sequences with Ms. Hyun-a. The second video has considerably more flashing sequences that could easily trigger seizures in individuals with photosensitive epilepsy.
In the upper left of the screen grab at left (click on it to enlarge) you can see a dance sequence that is being analyzed for seizure safety. The accompanying graph indicates levels of flash (luminance) that fail to meet photosensitive epilepsy safety guidelines. Visible at the bottom of the screen are the individual frames that make up the moving sequence. The flashing effect is created by the alternating frames of bright and dark images.
How come you haven’t heard about seizures from the #1 YouTube video?
- Viewers may not maximize the video to fill the computer screen. Therefore the image is too small to affect enough neurons to cause seizures.
- Viewers are not staring continually at the screen—maybe they’re laughing, doing the horse dance, or straining to figure out the lyrics
- The seizures are happening but without many outward signs, so they are not recognized as seizures.
If a neurologist tells you that you don’t need to worry about seizures from electronic screen exposure, because you’re not photosensitive, what does that really mean?
It means that when you were tested for your response to a white strobe light, an EEG didn’t detect a particular abnormal electrical pattern in your brain. (I’ve noted some limitations of this procedure elsewhere.) Epileptology looks for yes or no, typically relying on EEG to rule out epilepsy. If yes, possibly medicate; if no, it’s not a case the clinician will pursue.
It does not indicate that bright flashing and/or patterns from electronic screens don’t adversely affect your brain function.
Researchers have gradually come to consensus on exactly what the EEG must look like to indicate photosensitive epilepsy (the photoparoxysmal response): certain spike/wave patterns that appear in both brain hemispheres. In arriving at these criteria, researchers excluded three other types of EEG abnormalities that in prior research “qualified” as a photoparoxysmal response. Epilepsy researchers aren’t certain what the significance of these other abnormalities is, but because the other patterns cannot conclusively be associated with epileptic seizures, there’s little interest in further research.
So these other EEG abnormalities from photic stimulation don’t count, in current neurology practice, and nobody would even tell you about them if they were found in your EEG. You’d be told the EEG was normal, period. But what if these other abnormalities were a sign that neurological function is in fact disturbed by visual stimuli, but not to the point of a seizure?
Let’s say you had one of the three other EEG abnormalities (which you wouldn’t know about, because the EEG was deemed normal). Maybe these indicate that you’re vulnerable to symptoms of a visual-overload-not-to-the-point-of-seizures syndrome. Neurologists have been examining the overlap between epilepsy, photosensitive epilepsy, and migraines. More about this in a future post, but actually there are many overlapping symptoms and correct diagnosis can be difficult. So if video game exposure or photic stimulation produces headaches and visual disturbances, and an inconclusive EEG, it may be that the visual overload is triggering migraines. Or perhaps the exposure is triggering another form of hyperexcitability in the brain’s visual cortex, which has been termed visual stress. While research has been done on this, it’s not part of a conventional neurology practice.
What about patients with more subtle or mood-related symptoms of a visual-overload-not-to-the-point-of-seizures problem? Who is treating these patients? Could be psychiatrists and psychologists, who view altered behavior and cognitive function through the lens of their respective training. Because there’s such a dearth of research of the gray areas of brain dysfunction following exposure to electronic screens, mental health providers have no basis for treating these patients for anything but mental health disorders. It’s clear that more research is needed and that more effects on the brain will be uncovered. One intriguing paper explores the contribution of fluorescent lighting to agoraphobia. The SpongeBob study published last year showed diminished executive function in children who viewed the cartoon.
In her Psychology Today blog, psychiatrist Victoria Dunckley recently posted a compelling piece about the effects on her patients of electronic screen time. She recommends creating a diagnostic category called Electronic Screen Syndrome to identify a dysregulation of mood, attention, or arousal level due to overstimulation of the nervous system by electronic screen media. She has seen dramatic improvements in hundreds of patients’ mood, behavior, and cognition after they go on an “electronic fast.” (Some have underlying psychiatric diagnoses, some don’t.) Maybe these patients were having very subtle seizures from electronic screens. Maybe the effects on the nervous system weren’t quite what epileptology defines as seizures. Either way, many kids exposed to electronic screens are experiencing diminished quality of life (as are their families) for a problem that medicine has not yet acknowledged.