Fortnite: The game–and the seizures–are free

Fortnite’s High Explosives mode fills large areas of the screen with bright, rapidly moving images that can trigger seizures.

Maybe you’ve heard about the video game Fortnite that now has 45 million players? One reason it’s so popular is that it’s free to download — with its seizure-inducing graphics.

Playing Fortnite involves quite a bit of shooting that creates bright flashes. The flashes are especially likely to trigger seizures when the game is played in “high explosives” mode (available during limited release dates). The high explosives create bigger explosions splayed across larger areas of the screen, which in turn affects a greater number of neurons in the brain’s visual processing system. For reasons not entirely understood, in people with photosensitive epilepsy, flashing light and certain other visual stimuli overload the visual cortex in a way that leads to seizures.

A Fortnite “high explosives” weapon in action

In one user-uploaded, 7-minute, 39-second gameplay video using high explosives, 8 separate image sequences failed to meet the standards for minimizing the risk of visually triggered seizures. Each of those failures represents a visual sequence with a reasonable chance of setting off seizures in persons who have photosensitive epilepsy. The test for seizure risk from images is based on guidelines for reducing visually induced seizures, determined by extensive research on the image qualities that can bring on seizures in people with photosensitive epilepsy: motion, brightness, contrast, patterns, color intensity, and flash/flicker .

Please fix this, Epic!

Fortnite’s developer, Epic Games, has come out with remarkably frequent product updates to address performance bugs and keep players’ interest from flagging. (No issues with maintaining players’ interest level — maybe you’ve also heard about parents and teachers struggling to handle kids’ unprecedented preoccupation with this game?) Last week Epic removed a guided missile weapon from the game — for now — due to a bug and some player feedback that using the weapon disturbed the sense of fairness and balance of the game. That still leaves grenades, rocket launchers creating big flashes in high explosives mode.

Problem flash isn’t limited to explosions. The flash in this sequence came from spacecraft lights.

Perhaps the company’s unusually rapid product development cycle would make it possible to modify all the game’s graphics where the image sequences place users at risk of seizures? There are tools available to developers to identify the offending images — what I use to test the gameplay clips is just another version of the same Harding Flash and Pattern Analyzer software. You can read here about the way I do the testing.

Should you be concerned?

Maybe. Estimates are that up to 3 percent of the population has photosensitive epilepsy (among those with any other form of epilepsy, about 5 percent). Photosensitive seizures typically begin between ages 8 – 20, and they can occur in people with no history of epilepsy.  Of the hundreds of children who had seizures during a 1997 Pokémon cartoon broadcast in Japan, researchers found that 74 percent of them had never been aware of experiencing a seizure before.

The prevalence of photosensitive epilepsy is probably underestimated because seizures are not always noticeable, and therefore not always reported or even suspected. The symptoms of a mild seizure may be so subtle that nobody realizes what’s occurred. That doesn’t mean a mild seizure is nothing to worry about; any seizure has the potential to leave disabling physical and cognitive after-effects and mood changes that can last for days.

What can you do?

Parents and teachers are struggling to handle kids’ unprecedented preoccupation with Fortnite. To learn about the effects of video games on the central nervous system, and about finding ways to reduce your child’s screen time, I recommend Dr. Victoria Dunkley’s Reset Your Child’s Brain: A Four-Week Plan to End Meltdowns, Raise Grades, and Boost Social Skills by Reversing the Effects of Electronic Screen-Time.

To learn if your child may be experiencing game-induced seizures, ask about any weird sensations occurring while playing video games. See if you can get the child to wear cobalt blue dark glasses while gaming; in these are extremely effective at protecting against or reducing the severity of seizures.

CNET endorses 7 video games that can trigger seizures

Uncharted: The Nathan Drake Collection is the only one of CNET’s recommended games that didn’t fail the seizure test.

Wouldn’t it feel terrible to give someone a present that could set off an epileptic seizure? If you consult the CNET guide to video games for 2015 holiday giving, you’ve got 8 games to choose from–of which 7 contain seizure-inducing images. In the 3+ years that I’ve been testing selected video games for seizure-provoking graphics, this is easily the most lopsided result I’ve found.

The following table shows the games recommended in CNET’s “The best video games to give this holiday season” feature, with results of testing them for image sequences capable of triggering seizures. Testing is done with an application designed for this specific purpose (more info on that is below in the testing methdology section).

CNET’s choices for best video games to give this holiday season

Interpreting the results

Passing the seizure guidelines test means that in the 1.5+ hours of gameplay and cutscenes I tested, all image sequences meet well-defined guidelines for reducing visually induced seizures. I am not set up to test every possible sequence (video game developers should be able to do this, though). To get a “fail” on my tests, all that’s needed is one violation of the guidelines, which could occur within the space of a second or two. Again, since I do not test every possible sequence, it’s very possible–and likely–that the game also has other problem images that I didn’t test.

Your results may be different. Each person’s seizure threshold can be affected by a number of factors apart from the visual stimulus itself: illness, hunger, stress, fatigue, alcohol, medications, length of play, and others. So a game played without incident may trigger a seizure in the same player under different conditions. Also, players can be exposed to new and different image sequences in subsequent games.

CNET selected conventional action/adventure titles for its gift-giving guide. These games typically have plenty of shooting, explosions, and rapid movements that produce flicker in the seizure-inducing range of more than 3 flashes per second. In contrast, recent video game recommendations from both the New York Times and Los Angeles Times, with less tech-focused audiences, added some unconventional titles to their top picks. It’s worth noting that the less traditional games were less likely to fail the seizure test.

Uncharted: The Nathan Drake Collection–the one game CNET chose that meets the seizure reduction guidelines–is an action/adventure game, too, with some shooting and the occasional explosion, but designed without flickering images or other visual overload.

Images in Uncharted: The Nathan Drake Collection show explosions yet stay within seizure prevention guidelines.

Why it matters

Nobody wants to think about the risk of seizures that can be triggered by video games, figuring they’re extremely rare (they aren’t) and that the risk only applies to “people with epilepsy” (not so). Also, people assume that seizures are always of the grand mal type, with loss of consciousness, lots of involuntary movements, etc., so that they would be very obvious events (most seizures are not like this).

If you assume seizures are very obvious, then you also assume you’d hear a lot more about seizures that happen in front of computer screens and consoles. But many seizures are much more subtle, some so subtle that nobody realizes they’re happening. Even in these instances, though, the after-effects may mean impaired functioning for up to several days, or longer, affecting energy, concentration, memory, sleep, and mood. You can read here about how game-induced seizures we couldn’t see affected my daughter.

Vulnerability to seizures from bright flashes and rapid flicker, known as photosensitive epilepsy, is a genetic trait that’s latent in an unknown percentage of the population. This means that there are people with no idea they have this sensitivity to visual stimuli–until they are triggered and experience a noticeable seizure. So these people assume the seizure warnings accompanying video games don’t apply to them, or they just ignore them.

Testing tool and methodology

I run downloaded gameplay clips, cinematic clips, and promotional trailers for each game and submit the sequences to an application called the Harding Flash and Pattern Analyzer. (Graham Harding is one of the world’s leading experts on photosensitive epilepsy.) The FPA is widely used by producers and networks in the UK—including by the BBC—to reduce the risk of seizures from material on broadcast TV. I don’t know how many of the major game developers in this country use the FPA–they keep such information very much to themselves.

The analyzer examines video sequences for very specific and measurable image qualities that researchers have found can trigger seizures:

• rapidly alternating light and dark images (flash/flicker)
• certain stripes and geometric patterns with high contrast
• large areas of very bright (“saturated”) red
• problem images take up more than one quarter of the total screen area

If the first clip I test of a game fails the seizure guidelines test, I then move on to test the next game. If no guideline violations are found, I typically test at least 4 or 5 additional clips of that game–usually more, if I have a hunch due to the game genre and/or overall look of the sequences that there might be unsafe “footage” that I haven’t yet found. Most image sequences that fail the test do so because of strobe-like flicker.

Games that pass could have seizure-provoking sequences that I was unable to locate. I don’t do this testing while actually playing video games. Instead I work with video clips available online, some of which are official marketing and gameplay trailers; others are cutscenes and gameplay sessions posted by reviewers or fans. I avoid testing any clips of gameplay that were made using modifications to the original game software.

Other games I tested in 2015

This year I’ve tested also tested some other highly praised video games for their seizure risk (plus the games recommended by the New York Times and Los Angeles Times as noted above). Those results are here and here.

LA Times’ best video games of 2015: 4 can trigger seizures–and that’s progress

In the game Prune, players help trees grow.

The Los Angeles Times’  list of 10 best video games of 2015 includes 4 with images that could provoke a seizure. While this isn’t great, it’s not as bad a ratio as I typically find. Usually the best of year/best of show lists contain a higher percentage of games with a real seizure risk, so this is actually better than I expected.

The Times reviewer, Todd Martens, noted that this year there was a broader selection of games and they offered a wide range of player experiences and perspectives. And a number of his favorites are refreshingly novel in their imagery.

Martens writes about his choices in an accompanying piece entitled “Games in 2015 were better when they stepped away from the guns.”

“For a medium that for much of the last decade has been overrun with machismo, 2015 in video games represented a year of powerful role reversals. It was time, finally, to put down the guns… At a time, culturally, when mass shootings are part of our daily conversation, the industry’s over-reliance on games with guns is not only no longer fun, it’s exhausting.

The idea of swapping weapons for actual stories should be celebrated in any medium, but in gaming, where guns, bullets and senseless bloody murder have long ruled the day, it felt downright revolutionary.”

So here’s another reason to celebrate the appearance of appealing games that don’t rely on guns: without the widespread shooting, mayhem, and destruction that have dominated in many top-selling games, there are fewer scenes with flicker and flash that can provoke seizures. (It is quite possible, though, to depict such scenes without creating large, rapid, and bright flashes on the screen.)

I tested clips from the Los Angeles Times Top Ten list using an application that detects image sequences that can trigger seizures in vulnerable individuals. If you’re still doing holiday shopping, you might want to consider these results when choosing gifts. Here’s what I got:

Best video games of 2015 chosen by the Los Angeles Times

Disclaimers

Please remember that there are no guarantees your results will match mine and that many variables affect a person’s susceptibility to visually induced seizures. Each person’s seizure threshold can be affected by a number of factors apart from the visual stimulus itself: illness, hunger, stress, fatigue, alcohol, medications, length of play, and others. So a game played without incident may trigger a seizure in the same player under different conditions. Also, players can be exposed to new and different image sequences in subsequent games.

Testing methodology

I run downloaded gameplay clips, cinematic clips, and promotional trailers for each game and submit the sequences to an application called the Harding Flash and Pattern Analyzer. The FPA is widely used by producers and networks in the UK—including by the BBC—to reduce the risk of seizures from material on broadcast TV. I don’t know how many of the major game developers in this country use the FPA–they keep such information very much to themselves.

The analyzer examines video sequences for very specific and measurable image qualities that researchers have found can trigger seizures:

• rapidly alternating light and dark images (flash/flicker)
• certain stripes and geometric patterns with high contrast
• large areas of very bright (“saturated”) red
• problem images take up more than one quarter of the total screen area

If the first clip I test of a game fails the seizure guidelines test, I then move on to test the next game. If no guidelines violations are found, I typically test at least 4 or 5 additional clips of that game–sometimes more, if I have a hunch due to the game genre and/or overall look of the sequences that there might be problem “footage” that I haven’t yet found.

Games receiving a PASS could have seizure-provoking sequences that I was unable to locate. I don’t do this testing while actually playing video games. Instead I work with video clips available online, some of which are official marketing and gameplay trailers; others are cutscenes and gameplay sessions posted by reviewers or fans. I avoid testing any clips of gameplay that were made using modifications to the original game software.

Other games tested in 2015

I’ve tested additional video games this year for their seizure risk. You can find results here, here, and here.