Would you know if you just had a seizure?
Posted: 01/28/2012 Filed under: Diagnostic Challenges, Health Consequences | Tags: computer games, EEG, photic stimulation, photosensitive epilepsy, photosensitivity, seizures, Twilight: Breaking Dawn, video games 24 Comments
No, not necessarily. You might have no idea it happened, even. Multiple studies have shown that people often aren’t aware of their own seizures. When you consider that altered consciousness is characteristic of many seizures, it’s not so surprising. People who aren’t “all there” during the seizure may have no memory of it.
And if you have a seizure with subtle symptoms, anyone who’s with you may not realize it’s happening, either. This is a key reason many people haven’t heard much about video game seizures–many just go undetected.
The big seizures, of course, get noticed. Anyone nearby can clearly see a person who has fallen and is having convulsions. Individuals emerging from a grand mal seizure (what doctors now refer to as a tonic-clonic seizure) won’t remember the event itself, but will realize they’re not where they were before (perhaps finding themselves on the floor or in an ambulance), and may have bruises from uncontrolled movements.
Although studies show that photosensitive epilepsy can cause any type of seizure, a lot of clinicians still assume the condition produces only grand mal/tonic-clonic seizures. They may not know that partial and absence seizures are associated with photosensitivity, too. Click here for a list of some typical signs you may have had a seizure.
What are partial and absence seizures?
Partial and absence seizures can act like stealth attacks on the brain. They cause unusual behaviors and sensations, and may be followed by additional symptoms, but they often escape notice while the seizure is in progress.
Simple partial seizures produce temporary symptoms such as distorted vision or unexpected movement or tingling in one limb. Because they affect a small area of the brain, awareness and memory are not affected.
Complex partial seizures occur in 35 percent of people with seizures. Many types of behavior can take place during the seizure, depending on which parts of the brain are affected. Sometimes people may seem to continue whatever they had been doing, including talking with others. Sometimes during one of these events people are conscious enough to allow them to hear what’s going on around them–perhaps feeling everything is happening far away–but they aren’t able to speak. Because consciousness is altered, it’s not uncommon to have either no memory of what happened during the seizure or just a vague idea. The event can be over in 30 seconds, or it may last for a few minutes.
The seizures are typically followed by headache, temporary confusion, memory loss, and/or other neurological dysfunction, as well as fatigue and “brain fog” that gradually dissipate over a period lasting up to a few days. Lingering after-effects of complex partials can easily be more of a disruption to everyday life than the seizures themselves.
Absence seizures, where a person briefly stares and “zones out,” may be very hard to notice and can be mistaken for attention problems. Learning, memory, and social interaction are often affected by the gaps resulting from interruptions in awareness, but absence seizures are not followed by after-effects.
Research shows people often don’t detect their own seizures
In a study published in 2007 by Christian Hoppe and colleagues, 91 seizure patients were asked to record all of their seizures in a diary during the time they were being monitored on EEG. In instances where patients activated a reporting alarm just prior to or during a seizure, only two-thirds of the seizures were documented afterwards by the patients. The reliability of patient reporting was lowest when documenting complex partial seizures and seizures experienced during sleep. Of 150 complex partial seizures (verified on EEG) while subjects were awake, only 52.7 percent of the events were reported, even though subjects were periodically reminded to report all their seizures.
The study authors state, “Seizure-induced seizure unawareness is a frequent, but rather unrecognized, postictal [post-seizure] symptom particularly associated with seizures from sleeping and with CPS [complex partial seizures].” Now consider, what are the chances that a person who has never had a seizure before, or whose seizures have never been identified, will remember after the event that something unusual happened?
In the 2004 review article “Visual Stimuli in Daily Life,” Kasteleijn-Nolst Trenité and colleagues note that during photic stimulation testing many patients do not notice brief seizures that are detected on the EEG but have no clinical signs. “The question must be raised,” they continue, “whether asymptomatic individuals might have unnoticed reflex seizures triggered by daily-life stimuli and become overtly symptomatic only when a critical age is reached (early adolescence), in combination with lifestyle-related factors.” In other words, after adolescence, photosensitive seizures that were already happening but nobody was aware of may become more visible, possibly when the nervous system is affected by additional circumstances (lack of sleep, alcohol consumption, etc.).
Need more data? In a 1996 study of 27 seizure patients by Blum and colleagues, patients were not aware of 61 percent of their seizures detected on EEG! Seven patients didn’t recall any of their seizures. Patients were questioned periodically throughout the day as to whether they’d had a seizure or if anything unusual had occurred, so the seizures would be expected to be fresh in their minds.
Can an EEG help determine whether you had a seizure?
Let’s say something suddenly felt very weird yesterday, and you’re wondering if it was a seizure. An EEG conducted today can’t tell you if yesterday’s event was a seizure. That’s because EEGs can’t provide data on any period other than the time the electrodes are in place and recording brain activity. An initial EEG usually lasts for 20 to 30 minutes and can be thought of as an extended “snapshot” of brain wave patterns. If you have a seizure during an EEG, the EEG can confirm that it was a seizure–but only if electrodes pick up the brain waves that typically signify a seizure.
Usually at some point during the EEG you’re exposed to a strobe light to see if your brain has an abnormal response to flash. If that part of the EEG is abnormal, it can indicate that you have photosensitive epilepsy and should avoid flashing lights. The test is done in a way that doesn’t provoke an actual seizure, but it can show an abnormal “firing” of neurons that is consistent with seizures. Note that strobe lights may not create that EEG response even if a video game does–the flashing white light doesn’t make the same impact on the visual cortex that a colorful screen with lots of action. Some people don’t respond to the strobe but do have an abnormal EEG response to certain sharply defined patterns. Video games and TV may include some of these patterns, but little testing is done for pattern sensitivity in the US.
EEGs done with scalp electrodes miss a lot of seizure activity that involves a small area and/or lies deep inside the brain, far from electrodes on the surface. I’ve written about this before, but I can’t resist adding that this point was acknowledged in the above study by Blum et al. “…there are seizure types that often do not manifest on surface EEG. The most important of these is frontal lobe epilepsy, but this also occurs with complex partial seizures of temporal lobe origin.”
In fact, “it is crucial to recognize that a normal EEG does not exclude epilepsy, as around 10% of patients with epilepsy never show epileptiform discharges,” according to a 2005 paper in the Journal of Neurology, Neurosurgury & Psychiatry.
Seizures are more common and frequent than current technology and human memory can demonstrate.
Seizures from Video Games 
Dr. Dunkley makes some decent points. We could actually use a break from our devices. But she’s a fanatic. I just don’t like her silly scare tactics, it’s irresponsible. Screens aren’t the real issue. It’s the abuse of screens and the content. Like social media. Bad news sites and so on. It’s all just too much.
The much bigger problem hit when we started carrying too much of everything around with us in our pockets. There is too many apps on these phones. The phones can be useful if used for tools, and pertinent information. But I think we were better when we had flip phones. Even video games were better because we crowded around and bonded in the living room, and took ample breaks.
Also, here’s perspective on the Pokémon incident.
https://motherboard.vice.com/en_us/article/59mnax/did-pokemon-actually-give-kids-seizures-in-the-90s
The thing is, some individuals are more strongly affected by screen use than others. What you perceive as scare tactics are worst-case scenarios that Dr. Dunkley has seen in her practice. My daughter was a worst-case scenario, and the unseen seizures she was having in front of the screen severely affected her health for several years before anybody realized what was going on. It may seem like scare tactics if it doesn’t affect your own family. And it’s tough to know ahead of time whose brain will react to these stimuli with a seizure.
The link you provided is to a paper on the Pokémon incident that has does not dispute the fact that hundreds of children were affected by seizures and went to emergency rooms. The neurology literature for the most part discusses the Pokémon incident in terms of the available hard evidence–number of kids who went to emergency rooms during the broadcast, whose the medical records were available. As far as I know, the kids whose symptoms weren’t made known until later weren’t studied as a group for photosensitivity. There was little actual medical evidence collected on the larger group.
Jessica
[…] with a medical condition akin to seizures made me research more into epilepsy, EEG and neurology […]
I think I had one yesterday and I was alone…well, me and a 2 month old puppy. I got up to go shower. Dog was asleep In living room. I left the bathroom door open so she could find me. I got out of shower and dried off as the puppy came whining down the hall. I let her in bathroom as I dressed and came out to watch tv. I noticed my toenail was broken but wasn’t broken in the shower. I didn’t understand. Then I noticed both my calf muscles were very sore but not before my shower. Few hours later my tongue hurts so I take a look. All bitten up but when did it happen?? In the shower or out of shower is my mystery. I was watching my neighbors puppy and am so grateful I didn’t fall on her. Would have surely killed her. Next morning my arms and shoulders are very sore. It was a seizure. Withdrawals caused one about 4 years ago and I asked the paramedic why he was talking to me. The whole class then informed me in horror I just had a seizure. They picked me up off the floor, fixed my dress and put my wig back on. I remember none of that. 😯
I think I may of have a seizure today. I have never had one, but when I was going to the restroom, I felt extremely light headed, faintness, and noises started to blur/slur . I sat down on the toilet so I could take a breath. But next thing I knew, I was groggy and confused. I was using the wall as support, my glasses had fallen off somehow , the toilet was half ways off and my hands were jerking back and fourth slightly. I later went back to my room and asked my bf how long I was gone for and he said about two to three minutes. With me thinking I was only there momentarily.
I’m 27 and I was diagnosed with GBM (Glioblastoma Multiforme) a few months back, after my Chemo and radiation I had my first seizure yesterday I don’t even remember other than being told I was going to the ER.
Not sure if I had a seizure but yesterday I was standing still, picking up some cups on my nightstand, when I kinda started twisting, feeling like I was going to fall. The only thing I remember was holding the cup and grabbing a hold of my bed. I vaguely remember leaning over the bed and feeling I was jerking. When I “came to” my whole body was shaking and tight. I didn’t realize I had blacked out for a few seconds until I saw I had dropped the cup and there was a mess everywhere! I had no idea or memory of how the cup dropped. All I know is I blacked out, felt myself shaking uncontrollably, and came to with no teal memory of what happened. My left cheek felt twitchy and my abdominal muscles felt like I had been working out and my left hip hurt a little to walk afterwards, I felt a little dizzy. I have lupus so I’m a little freaked out. Does this sound like a seizure?!
It certainly sounds like a possibility–but I can’t say without more expertise. I’d like to suggest, as I did to another person with a question like yours, that you try the community forums at epilepsy.com, where your query will be seen by many more people who have experienced seizures themselves (I haven’t). You have to scroll down the page to get to the forums. Best of luck.
Jessica
Im curious if I had a seizure or not I dont remember much but my husband filled me in anyways here it goes. I had been geeling ill all day upset stomach we went to go to bed and after a few mins i felt nauseous so i went to the bath room i remember standing and heaving once then all the sudden i hear my husband saying my name and i came to my head started spinning and i threw up all over. He said when he found me i had my head flopped to the side with my hair in front of my face and was mumbling moaning and gaging. He moved my hair away from my face said my eyes were wide open and i was drooling he tried shaking me moving my head and i was unresponsive till i finally came to when i started puking. I lost all memory of what happened from point of standing and then i was on the floor puking. Apparently at some point i also (tmi) lost cobtrol of my bladder. Just curious if anyone thinks it sounds like one or i was just really sick and passed out. Thanks and i hope i hear from someone.
Kelsey, probably the best place for you to get some feedback on what happened to you (other than a doctor) is at the community forums on the epilepsy.com website, where visitors engage in back-and-forth. There isn’t a lot of conversation here. Best of luck.
Jessica
Kelsey, it actually does sound like you had 1 so if it has happened again or does happen again consult your PCP asap to get a referral to an internalist and/or neurologist. However, it could have happened due to different reasons. It also depends on whether you have had problems similar to this before that one. You could have had a seizure because you might have a partial disorder or you could have been so sick your body actually caused your brain to “freeze”.
I have had seizures for many years it sounds like many I have had. One almost word for word like yours. I’ve been diagnosed w/several different types including partial seizures. Wikipedia is a good simple source on seizures (easy to understand). It also gives you many sites to check out. I prefer to read from sites like epilepsy.com, Mayoclinic.com, WebMD.com & even medscape.
Thank you, Janey, for your reply to Kelsey.
Jessica
I am 53 female was drinking and felt like I was going to be sick. I found myself on the floor with my body jerking and very tight. My breathing was very loud and my head was rolling side to side. This as never happened to me before. I am not a heavy drinker. I do not drink every day. I was with my sister, she said that she had only been to bed for 15mins. so I don’t know how long I was in there before I called for her. Do you think this could have been a seizure or maybe I just passed out? Thank you for your time. Gwendolyne
I can’t know if was a seizure, but I do know that alcohol lowers the seizure threshold. If you had more to drink than usual, you might have become more vulnerable to having one. Other situations that lower the seizure threshold include illness, hunger, sleep deprivation, and stress.
Jessica
Hello,,I would like to share an episode I had a few weeks ago,,I was finished grocery shopping, talking to my son who is a manager at the store. I finished my sentence and a feeling came over me as if all my energy was draining out of me. I said the word “whoa” and my son asked what was wrong. I said I don’t know but I feel very week and have no energy,,maybe I’m having a heart attack. He said my speech was slow and that I’d turned pale and then I turned red in the face and I started sweating and my tongue became numb. Needless to say, when he got me to the E.R., I was treated as a cardiac patient,, my blood pressure and pulse were elevated. My doctor and a cardiologist were called and recommended a stress test which found some shadows. I was transferred to another hospital and had a heart cath done which proved to be normal. I’m following up with a neurologist as I had seizures (gran-mal) at the age of 10-12. My mother and her father suffered from strokes and seizures. I am other wise healthy, except for having bladder/kidney problems and I just turned 60 yrs. old (female). I’m wondering what your opinion is of this episode. Thank you
That must have been frightening. Did you lose awareness of your surroundings? Were there any other sensations? It’s sounding like it was probably something else, not a seizure.
Jessica
No, I knew where I was at all times, I just had the feeling as if I was losing all my energy and it scared me so that I started shaking as well,, I actually thought I was dying,,,,
Here’s something to consider, Erelene–I recently came across some info on partial seizures and panic attacks and how it can be tough to tell them apart. Check these articles out and see if that helps at all: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1118775/ and http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1118775/
Jessica
On Sat, Oct 17, 2015 at 9:21 PM, Seizures from Video Games wrote:
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Thank you, Jessica for the links you gave me,,it’s remarkable how panic disorder and partial-seizure is so much alike. The day of my episode was actually a good day for me. I felt very well, both mentally and physically, then basically out of no where, “it” hit. My appt. with a neurologist is soon and I hope to get an an answer.
IM not sure what happened but I blacked out and fell my pupils dialated to the point where they looked like needle pricks and I had a very low pulse I don’t remember the last few days could this have been a seizure??
I’m not a physician so I can’t really say. In seizures, though, I do know it’s much more common for pupils to become very enlarged rather than smaller.
Jessica
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Hi,
I love your website and all of the information you are providing. I have been researching this topic for the past year and have found most of the same information. One of my nephews has been damaged by years of computer and video game use. It has damaged his ability to remember much – long term.
I recently found the book ‘Endangered Minds’ by Jane Healy. She first published the book in 1990. Chapters 10 and 11 cover video games, cartoons, and the effects of ‘Sesame Street’.
I recommend it.
Thanks for all of your hard work.
Marian
I’m guessing your nephew is still playing computer games? If he were able to stop, I think (I can’t say this for sure, nor am I an MD) a lot of his neurological function would return. Memory problems are very common in the days following a seizure. When my daughter has a seizure-free stretch, her mind just works better — mood, focus, flexibility, planning, and memory.
Thanks for recommending Jane Healy’s book. I look forward to reading it. Have you seen the website of Victoria Dunckley, MD? She writes about the effects on mood from electronic media’s visual overstimulation.