Video game exposure in children with epilepsy: EEG and clinical findings

Objective: To investigate the effects of video game exposure on pediatric epilepsy patients, focusing on electroencephalography (EEG) and clinical outcomes. Methods: A total of 94 pediatric epilepsy patients aged 6-18 years (juvenile idiopathic generalized epilepsy, childhood absence epilepsy, self-limited idiopathic focal epilepsy [SeLEAS and SeLECTS]) and 57 non-epileptic controls were enrolled. EEG recordings were obtained while patients were awake, asleep, and during video game play. The impact of video games was analyzed across different epilepsy subgroups and according to epilepsy control status. Results: Twenty-five patients with EEG deterioration in the entire group, three of whom were from the control group (p = 0.032). Among juvenile idiopathic generalized epilepsy patients, 2 of 21 controlled and 6 of 11 uncontrolled patients were adversely affected by video games (p = 0.01). In the SeLECTS group, none of the controlled patients and 3 of 11 uncontrolled patients showed adverse effects (p = 0.063). In the absence epilepsy and SeLEAS groups, epilepsy status did not significantly affect video game response (p = 0.250, p = 0.603). Patients with pattern sensitivity and photosensitivity had a higher risk of EEG deterioration during video game play than those without these sensitivities. Conclusions: Playing selected video games is safer for patients with juvenile idiopathic generalized epilepsies and the SeLECTS group when precautions are taken, and both EEG and clinical conditions are under control. However, video games pose a risk for patients with absence epilepsy and SeLEAS, regardless of epilepsy control status. These findings underscore the need for individualized assessments and tailored recommendations for video game exposure in pediatric epilepsy patients.