title: Mah-Jong-induced epilepsy: a special reflex epilepsy in Chinese society.
abstract: We present five patients of epilepsy in which seizures were triggered by playing or watching the traditional Chinese gambling game "Mah-Jong." One patient also experienced seizures while playing a computer version of the Mah-Jong game. This condition appeared to have a predominance of males (80%) and middle-aged onset (39.4 years). Four patients had generalized tonic-clonic seizures and one patient had partial seizures with secondary generalization. No spontaneous seizure occurred in these patients. Three patients had been receiving antiepileptic drug therapy, but without effective control over their seizures. Mah-Jong-induced epilepsy is a very peculiar form of complex reflex epilepsy that involves the higher mental activities. This phenomenon may consist of distinct pathophysiologic mechanisms from other reflex epilepsy induced by thinking and spatial tasks in idiopathic generalized epilepsies. This unusual reflex epilepsy is relatively benign in nature and antiepileptic drug therapy has uncertain benefits. It may be necessary to avoid playing the Mah-Jong game in order to prevent seizures.
authors.affiliation: Department of Health and Leisure Management, Fooyin University, Kaohsiung, Taiwan.
authors.forename: Chin-Lung
authors.initials: CL
authors.lastname: Wan
authors.forename: Tsu-Kung
authors.initials: TK
authors.lastname: Lin
authors.forename: Cheng-Hsien
authors.initials: CH
authors.lastname: Lu
authors.forename: Chen-Sheng
authors.initials: CS
authors.lastname: Chang
authors.forename: Shang-Der
authors.initials: SD
authors.lastname: Chen
authors.forename: Yao-Chung
authors.initials: YC
authors.lastname: Chuang
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D001143:Arousal / Q000187:drug effects / Q000502:physiology; D044466:Asian People; D001927:Brain Diseases / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D002540:Cerebral Cortex / Q000473:pathology / Q000503:physiopathology; D004569:Electroencephalography; D004828:Epilepsies, Partial / Q000188:drug therapy / Q000208:ethnology / Q000503:physiopathology; D004829:Epilepsy, Generalized / Q000188:drug therapy / Q000208:ethnology / Q000503:physiopathology; D020195:Epilepsy, Reflex / Q000188:drug therapy / Q000208:ethnology* / Q000503:physiopathology; D004830:Epilepsy, Tonic-Clonic / Q000188:drug therapy / Q000208:ethnology / Q000503:physiopathology; D005260:Female; D005715:Gambling; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D013624:Taiwan; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants