title: Clinical characteristics and prognosis of mah-jong-induced epilepsy: A cohort review of 56 patients.
abstract: OBJECTIVE
  The objective of this study was to investigate the clinical characteristics of reflex epilepsy elicited by playing mah-jong in Western China.
  
  
  METHODS
  Consecutive patients with reflex epilepsy triggered by mah-jong from Jan 2011 to April 2014 were recruited at West China Hospital. Each patient underwent EEG recording and brain MRI scan. All clinical data were reviewed. Each patient had at least 12 months of follow-up.
  
  
  RESULTS
  Fifty-six patients were included, with majority of them being male (52/56, 92.9%). Mean age was 43.9 ± 10.0 years. Mean age at seizure onset was 35.1 ± 16.3 years. Mean duration of reflex epilepsy was 4.0 ± 2.2 years. The mean follow-up time was 32.0 ± 13.2 months. Seventeen patients (30.4%) took antiepileptic drugs. Regardless of the medication, all 14 patients who avoided playing mah-jong reached seizure freedom, and 22 of the 42 patients (52.4%) who still played mah-jong continued to have seizures (p<0.05).
  
  
  CONCLUSIONS
  Reflex epilepsy induced by mah-jong is a unique type of epilepsy in the Chinese population and usually occurs in adults after a long time lag of playing mah-jong. Avoiding the triggers is the most effective treatment for epilepsy.
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Chengdu, 610041, China.
authors.forename: Dongmei
authors.initials: D
authors.lastname: An
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Chengdu, 610041, China.
authors.forename: Xuemei
authors.initials: X
authors.lastname: Zou
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Chengdu, 610041, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Chen
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Chengdu, 610041, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Yan
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Chengdu, 610041, China.
authors.forename: Ling
authors.initials: L
authors.lastname: Liu
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Chengdu, 610041, China. Electronic address: zhoudong66@yahoo.de.
authors.forename: Dong
authors.initials: D
authors.lastname: Zhou
mesh_terms: D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000627:therapeutic use; D001143:Arousal / Q000187:drug effects / Q000502:physiology; D044466:Asian People; D001921:Brain / Q000473:pathology*; D002681:China; D004569:Electroencephalography; D020195:Epilepsy, Reflex / Q000175:diagnosis* / Q000188:drug therapy / Q000208:ethnology; D005260:Female; D005500:Follow-Up Studies; D005715:Gambling; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012640:Seizures / Q000188:drug therapy; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants
keywords: Mah-jong; Outcome; Reflex epilepsy