An Epileptic’s Guide To Gaming

A typical false impression about seizures is that they solely occur to individuals with epilepsy. That’s not true; seizures can happen in anybody. There can be no “one type” of epileptic episode, which implies studying about triggers is usually a difficult course of. With accessibility in gaming turning into more of a priority inside the gaming house, studios are lastly starting to take a look at the impression of sure results on these prone to neurological episodes past merely slapping a warning label on video games and calling it a day. 

As somebody who has seizures attributable to an damage from my time once I was lively obligation, the years following this new improvement have been a steep studying curve for me when navigating a few of my favourite and most anticipated video games. I now not can get pleasure from titles like Dead Space freely as I used to, which opened up a wholly new world of improvement that by no means even entered my scope of consciousness. Since seizures have change into my new norm, I typically be sure to pay particular consideration to sure design selections that may be dangerous to these delicate to neurological traps. That method, I can determine for myself if one thing is protected to play, and see if there’s a strategy to work round these obstacles and attempt to supply some navigational instruments for others that could be dealing with comparable roadblocks. For those that expertise any sort of seizure or those that dwell in the identical family with somebody with epileptic tendencies, right here is our Epileptic’s Guide to Gaming. 

An Epileptic’s Guide To Gaming

I opened up about sure sorts of triggers in an article back in December concerning Cyberpunk 2077. Since then, CD Projekt Red took the required steps to make (very) small tweaks to make the title a little bit safer for all. I’ve additionally been hit with a plethora of questions from players with epilepsy, dad and mom of youngsters prone to seizures, and studios seeking to make extra educated design selections. Because of this curiosity, and within the curiosity of constant to make gaming one thing that everybody can get pleasure from, listed below are a number of suggestions that I’ve discovered via the years when approaching new adventures within the digital house. But first, let’s discuss concerning the completely different forms of seizures earlier than laying out some suggestions. 

Different shades of epilepsy 

It’s necessary to do not forget that epilepsy is a broad time period protecting many particular areas of neurological divergence. It’s not “one” illness, there are a lot of completely different patterns and triggers that differ from individual to individual. While medical doctors and scientists proceed to study extra about epileptic triggers and methods to forestall them, here’s a basic overview of the different types of epilepsy and the related signs with them: 

  • Generalized epilepsy
    • Seizures begin on either side of the mind with two distinct sorts of signs:
      • Generalized motor seizures, often known as Grand Mal seizures, may cause a lack of physique management, lack of consciousness, and a stiffening/tweaking of muscle tissue
        • Terminology contains clonic, tonic, and myoclonic
      • Generalized non-motor seizures, often known as Petit Mal seizures, typically leads to a “zoning out” for the individual affected, small tweaks to facial options (most typical is lip-smacking)
        • Terminology contains typical, atypical, and myoclonic 
        • Also referred to as “absent” seizures as a result of it will probably look like the individual affected is not “really there”
  • Focal epilepsy
    • Seizures will usually deal with one a part of the mind, additionally referred to as “partial seizures”
    • Focal epilepsy is often categorized into 4 classifications: 
      1. Focal conscious – the individual is “aware” of the seizure taking place
      2. Focal-impaired consciousness – the individual is commonly confused throughout an episode, typically with no recollection in any respect
      3. Focal motor – the individual will expertise some uncontrolled motion (twitching, muscle spasms, repeat extremity actions, aimless strolling)
      4. Focal non-motor – the individual affected normally will not exhibit exterior signs; as a substitute extra inside features are current like confusion, coronary heart racing, a drastic drop in temperature, and extra
  • Generalized and focal epilepsy
    • This means the individual affected has a mix of the 2 epileptic varieties seen above
    • This is the kind I’ve
  • Unknown
    • There remains to be a lot unknown about epilepsy and the way it’s precipitated, what triggers it, and therapy 
    • Unknown categorization implies that a seizure can occur at any time, lengthy after start, and signs/triggers don’t have any discernible sample

Triggers come from quite a lot of locations. For me, flashing lights at a sure price can nearly assure a seizure. This is one thing most photo-sensitive epileptics have to pay attention to. While typically seizures can happen with no discernable set off, a number of widespread irritants are recognized which might be good to pay attention to: 

  • Sleep deprivation
  • Specific hours of the day
  • When you are in poor health or with a fever
  • Stress
  • Flashing lights at a sure price, velocity, and shade (mostly crimson and white)
  • Alcohol or extreme drug consumption
  • Women can typically be extra prone with their menstral cycle
  • Diet restriction, drastic modifications in weight-reduction plan
  • Certain drugs
  • Heat or excessive chilly
  • Hormone shifts
  • Excess caffeine


Knowing what kind of epilepsy you expertise (or these round you expertise) is essential. Still, the truth is that so many individuals go undiagnosed as a result of it is laborious to identify, particularly with the focal varieties. They might be troublesome to doc in an expert setting, as properly. I skilled seizures for 2 years earlier than my physician was lastly capable of discern a sample to set off one. He was capable of seize a seizure on-camera in a managed setting. Because it is laborious to diagnose – or can typically even be a one-off incidence – there are not any set tips for stopping them. That being stated, the beneath tips are what I’ve applied in my every day life concerning video games, motion pictures, and TV:

  • Sit at the very least two ft away from the display, if doable
  • Try to maintain your gaming space properly lit to scale back the impression of flashing lights as the only focus
  • Dim your display’s brightness
  • Invest in a monitor/TV display that gives an Eye-Saver Mode. This will remove blue mild, which has helped me with crimson and white flashing
    • Some screens supply glare guards and flicker-free settings
    • “Gamer glasses” like from Gunnar additionally assist as properly, particularly if an eye-saving mode monitor is not accessible right now
  • Try to not play a sport should you’re in a state of utmost exhaustion
  • Don’t neglect to take breaks, typically
  • Pay consideration to how you feel
    • If you begin to really feel “off,” do not ignore that. Identify what triggered that change in feeling and take a second to step away
  • In excessive situations (for video games like Cyberpunk 2077), you can even alternate protecting one eye over the opposite and switching off periodically
    • This is particularly useful for focal epileptics
  • Try to not play something when you’re residence alone, if doable
    • If you reside alone, have a plan in place with a detailed good friend or neighbor do you have to need assistance

Do video video games “cause” epilepsy?

No! They can set off epileptic episodes, however you will not out of the blue develop a bent for seizures by taking part in loads of video games. “It’s quite clear that the exposure to video games does not make you become an epileptic,” says Giuseppe Erba, M.D from the University of Rochester Medical Center, in tips from the Epilepsy Foundation. Video video games additionally impression a a lot smaller quantity of individuals than you may suppose. While the precise quantity remains to be unknown, it’s estimated that youngsters that exhibit photo-sensitive seizures solely quantities to about 4-9% of the inhabitants. Adults are more durable to diagnose for a numeric measurement attributable to prognosis problems, however susceptibility does go down with age. 

“The risk of having a seizure if you are sensitive is only one out of 17,000 viewers if you are young,” continues Erba. “If you are older, it’s even less. It’s one out of 90,000.”

Those numbers sound low, proper? While the reply to that’s sure, that does not imply that studios cannot take the steps wanted to make video games safer. Sometimes the modifications are so minuscule {that a} participant would do not know a change even occurred until they had been instructed. While the variety of epileptics which might be confirmed with a prognosis is comparatively small, there are such a lot of that aren’t recognized and situations the place a seizure happens with no earlier disposition. 

Looking forward

In my case, my epilepsy is a symptom, not a trigger. I by no means had a single neurological situation earlier than the service, however a mind damage modified that for me. When I suffered my first Grand Mal seizure whereas taking part in Deadpool on the Xbox 360, I nearly died. I misplaced management of my total physique (together with continence, which is a little bit embarrassing), and my husband says that I used to be screaming that my pores and skin was on hearth. Since then, I’ve had quite a few Grand Mal seizures. I’m continuously studying new triggers and methods to make day-to-day life safer. TV, motion pictures, video games – all of them probably might set off a seizure for me and lots of like me, and typically, these seizures might be deadly. 

I just lately sat down with Microsoft’s senior gaming accessibility program supervisor, Brannon Zahand, to debate how Xbox is making strides with sport improvement and epileptics. “We’re always exploring new ways where we can innovate in the accessibility space, whether it’s hardware, games, the platform itself, or our services,” he told me. “Epilepsy was actually one of my first experiences with the disability community. When I was in fourth grade, a coach of mine had a seizure on the court while we were playing, which caused a significant injury when he fell. I think many people simply don’t understand how impactful and dangerous a seizure can be. So it’s a topic my team, and I bring up regularly when working with publishers and developers.”

He added, “We also have developed the Xbox Accessibility Guidelines (or ‘XAGs’), which are a set of best practices we defined in partnership with members of the Gaming & Disability Community and with other industry experts. We share these with developers, which they can use for design ideation as well as validating the accessibility of their games. We have one XAG devoted to photosensitivity which suggests avoiding sure show patterns and the usage of industry-standard exams to assist guarantee merchandise are as protected as doable.

“As for working with people with disabilities, the Xbox User Research Team has been doing a fantastic job of helping us bring more and more of the disability community in to provide us with feedback on our products. That includes individuals on the neurodiversity spectrum. And we have other mechanisms in place as well, such as Inclusive Design Sprints and a Gaming Accessibility Boot Camp, where our studios have the opportunity to sit down face-to-face with our community and take their feedback.”

With the strides in accessibility via the years, I’m assured that extra gamers than ever earlier than can benefit from the world that gaming has to supply. If you might have any questions, please be at liberty to drop a remark beneath! I additionally advocate studying extra with the Epilepsy Foundation of America, a useful resource that has been invaluable in ongoing analysis and assist for these frightened about doable epileptic tendencies. 

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