Reflex epilepsy induced by playing Go-stop or Baduk games

PURPOSE Seizures can be triggered by complex mental activities. The aim of this study was to investigate the clinical characteristics of reflex epilepsy induced by playing Go-stop or Baduk games. METHODS The study comprised 11 patients with this type of reflex epilepsy identified from our patient database. We collected data on clinical features, EEG, and brain MRI as well as seizure outcomes. RESULTS The patients had a late age of onset (range, 43-65 years, except for one patient with an age of onset of 11 years). An MRI abnormality and interictal EEG abnormalities were found in one patient respectively. The seizures exhibited diverse semiological features suggesting a focal or generalized onset. No myoclonic seizures were observed. Individualized strategies such as avoiding the precipitating game or reducing exposure to the stimulus were most effective in preventing the seizures. CONCLUSION The pathophysiological mechanisms underlying Go-stop- or Baduk-induced seizures may be different from other cognition-associated reflex epileptic phenomena. This type of reflex epilepsy may be a heterogeneous syndrome manifesting in a range of diverse semiological features.