Epilepsy :: Chinese tile game Mahjong can induce epilepsy

Playing the popular Chinese tile game mahjong can lead to seizures, Hong Kong researchers say, calling the phenomenon “Mahjong induced seizures” or ‘Mah-jong epilepsy’.

Mahjong epilepsy is a rare reflex epilepsy syndrome, manifesting as recurrent epileptic seizures triggered by either playing or just watching mah-jong.

Mahjong is a game for four players that originated in China. Mahjong involves skill, strategy, and calculation, as well as a certain degree of luck. Depending on the variation which is played, luck can be anything from a minor to a dominant factor in success. In Asia, mahjong is also popular as gambling or computer games. The object of the game is to build complete suits – or melds – usually of threes, from either 13 or 16 tiles. The first person to achieve this goal wins the game. The winning tile completes the player’s set of either 14 or 17 tiles.

Researchers present three patients with this condition and review all the reported cases. Mah-jong?induced seizures can be considered a subtype of cognition-induced epilepsy. Nonetheless, these patients have distinctive clinical and electrophysiological features: late age of onset, different seizure patterns, single seizure-trigger, lack of spontaneous seizures, and electroencephalographic findings not supportive of idiopathic generalised epilepsy. The pathophysiological mechanism underlying mahjong induced seizures may be different from the other cognition-associated reflex epileptic phenomena.

Keywords: Cerebral cortex; Electroencephalography; Epilepsy, generalized; Epilepsy, reflex; Gambling

Mah-jong?induced seizures: case reports and review of twenty-three patients
By
Richard SK Chang, Raymond TF Cheung, SL Ho, Windsor Mak
Department of Medicine, Queen Mary Hospital, Hong Kong


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