Abstracts

Rationale: Visual stimulations (e.g. alternating red/blue stimulus or flashing lights) during video games and TV programs have shown to provoke seizures. In the Pokemon Case 1997 approximately 100.000 Japanese children saw the video Denno Senshi Porygon , 685 were hospitalized with suspected epileptic seizures. In 2010 a 42-year-old man in Taiwan has died while watching the 3-D epic "Avatar". The manufacturer SAMSUNG warns of dangers of 3D Television in his homepage: Some viewers may experience an epileptic seizure or stroke when exposed to certain flashing images or lights contained in certain television pictures or video games... Even those without a personal or family history of epilepsy or stroke may have an undiagnosed condition that can cause photosensitive epileptic seizures Negative side effects of 3D-TV on EEG in epilepsy patients has not been systematically examined yet. Methods: Until the 31st of May 2011 we examined 100 consecutive patients with two sequences of EEG. EEG was performed due to a possible risk of unknown epilepsia (mainly headache or ADHS) or known epilepsy with or without seizures. The first sequence consisted of 20 min of routine (awake and/or sleep) EEG including photo stimulation followed by a sequence of 15 min viewing 3D-TV. We used a Panasonic 50 3D-Plasma TV with 3D shutter glasses in a room with 9 square meters. The viewing distance was about 2 meters measured between the patient and the TV. EEG was visually examined by two independent professionals (GK and LN-R). An IRB approval was obtained by University of Munich. Results: 100 Patients were recruited until completion of this abstract (mean age 12, 46 male, 54 female). 61 had epilepsy (see table 1); 39 Patients had no diagnosed epilepsy. 9 Patients had photoparoxysmal reactions (PPR) under photo stimulation during routine EEG (see table 2). 2 patients (female, age 9, 14) had positive PPR under photo stimulation and no history of seizures. In one patient with epilepsy (seizures 3-4 times a day), a seizure occurred during watching 3D. In all other examined patients no seizure could be provoked, nor the epileptiform paroxysms increased while viewing 3D. In three cases (all with generalized epilepsy) the frequency of epileptiform paroxysms were reduced during 3D-TV. Nevertheless, 20% of the cases presented symptoms like nauseas, headache and feeling of dizziness under 3D-TV and 15 % under photo stimulation. In most patients a significant increase in lambda-waves was observed during 3D-TV.Conclusions: In our cohort of children with a risk of epilepsy or with known epilepsy 15 minutes of viewing 3D-TV did not increase epileptiform paroxysms on EEG nor could we see provoked seizures. The chance for people with undiagnosed epilepsy to have an epileptic seizure provoked by 3D-TV is unlikely. It seems to be not a matter of technology, rather a matter of appropriate content, independent if 2D-TV or 3D-TV is used. A high percentage however reported symptoms like nausea, headache and feeling of dizziness together under 3D-TV. We interpret the significant increase in lambda-waves as a normal augmentation of saccadic eye movements.