Selfie epilepsy

P.M. Brna and K.G. Gordon.  “Selfie-Epilepsy”: A Novel Photosensitivity.   Seizure.  In press.

Abstract

Purpose

Photosensitivity is a well-described phenomenon; affecting a relatively small proportion of individuals with epilepsy. Typically people with photosensitive epilepsies are at risk of seizures induced by shimmering natural light, strobe lights and with particular patterns or flicker frequencies on television and video games.

Methods & Results

We present a novel case of photosensitivity captured during video EEG monitoring showing reproducible photosensitivity with the ever-popular social phenomenon; the “selfie.” The patient had previously demonstrated photosensitive myoclonus with intermittent photic stimulation on routine EEG.

Conclusion

This case suggests that taking “selfies” may represent a new area of caution for those with photosensitive epilepsies.

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From the article

The popularity of the self-photograph coined “selfie” has risen dramatically over the last several years. In recent years, the risks of taking selfies in precarious situations such as driving or posing with weapons have become increasingly apparent. However, there may be additional unique risks for those with photosensitive epilepsy as many camera phones use a pulsed LED flash to enable red eye reduction prior to taking a photo in a dark environment. We are not aware of any previous reports of a photoparoxysmal response demonstrated while taking a “selfie”. Herein, we describe a patient with previously documented photosensitivity, clinical myoclonus and photoparoxysmal response to taking a “selfie” with a smartphone…

In addition, we noted time-locked bursts of generalized spike wave with the patient’s use of an iPhone-5 camera to take “selfies” with flash and red-eye reduction in a dimly-lit room. This was

only seen with the camera held close to the patient’s face at arm’s length. The adolescent was not aware of any unusual jerks with these paroxysmal EEG discharges and no accompanying myoclonus was seen on video monitoring…

The popularity of the “selfie” photo continues to grow being used by celebrities, politicians and the general public alike. Though photosensitivity is fairly uncommon among those with epilepsy, people with photosensitive epilepsies must be aware of potential triggers. The finding of a photosensitivity response to a “selfie” raises concern over this seemingly harmless everyday activity for those with a prominent photosensitive response. Injuries while taking “selfies” have already been frequently documented in the media but those with photosensitive epilepsies may need extra caution. There are reports of deaths and serious injury incurred while taking “selfies” and of frequent “selfies” taken while driving motor vehicles. If a person with epilepsy were to have myoclonus induced by the flash of a “selfie” they could certainly sustain significant injury; particularly if they were already in a dangerous situation.

There are frequent warning labels for people with epilepsy pertaining to the use of video games. Many of these are not substantiated by evidence of a real elevated risk of seizure while playing the particular video game. Nevertheless, these warning labels are pervasive. However, mobile phones capable of producing “selfies” with provoking flash frequencies do not come with any such

warning. We feel that this is an area for further consideration. Our finding was isolated to one patient discovered incidentally during continuous video EEG monitoring and should be corroborated in other individuals with known photosensitivity on EEG before any official warning labels would be recommended.