The rise and fall of Dark Warrior epilepsy

Of all the names for a neurological disorder in the history of medicine, the most awesome has got to be ‘Dark Warrior epilepsy’.

The condition was reported in a 1982 edition of the British Medical Journal and was so named because the patient had seizures – but only while playing the Dark Warrior video game.

The game was actually a coin-up arcade machine and, despite the dodgy graphics, it is notable for being one of the first machines with an attempt at simulated speech.

The patient was a 17-year-old girl whose father was a video game engineer. He fixed the arcade machines and so she got to play for free.

Curiously, the case report mentions that she had already mastered Space Invaders, Asteroids, and Lunar Rescue.

Old skool video game freaks will be reading this and quietly thinking to themselves, respect, but the more medically inclined might be scratching their heads wondering why a patient’s video-gaming history has been included in their case report.

I mean, I ruled at Elite, but it’s never been mentioned in my medical notes.

The reason, is that only year before, the first ever case of epilepsy triggered by a video game was reported. It was named ‘Space Invader epilepsy’ because it was triggered by the arcade game Astro Fighter and the neurologist clearly didn’t know the difference between the original arcade classic and one of the cheap knock-offs.

The 17-year-old girl from Bristol, however, wasn’t troubled by Space Invaders, nor a host of other video games. She played them all with no problems at all. It was only Dark Warrior that affected her brain and, in fact, it was only a very specific scene in the game that contained a bright multicoloured flashing sequence.

The doctors treating the girl thought it was worth sending the case to a medical journal because video games were still very new in 1982.

But despite using the name ‘Dark Warrior epilepsy’ for this particular case they came up with another name – almost as awesome – for similar seizure disorders: ‘electronic space war video game epilepsy’

They then wrote what can only be described as one of neuroscience’s great paragraphs:

The term Space Invader epilepsy is, in fact, a misnomer, since no cases have been reported with the Space Invader video game itself. We suggest, therefore, that Astro Fighter and Dark Warrior epilepsy be classified under “electronic space war video game epilepsy” and this as a special category of photoconvulsive epilepsy. Video games other than space war games – for example, Super Bug and Munch Man – appear to be less epileptogenic. Electronic space war video game epilepsy has yet to be reported with Defender, Space Fury, Lunar Rescue, or Asteroids war games.

At the time, there was much media panic about ‘video games causing epilepsy’ but the real story is actually far more interesting.

Neurology nowadays doesn’t talk about specific game titles but it still considers the effect of video games on the likelihood of triggering seizures.

Firstly, let’s make it clear that video games don’t cause epilepsy, but the reason people can have seizures while playing is not because of the video game per se, but because of a type of neurological disorder called reflex epilepsy that can be triggered by idiosyncratic features of the environment.

The most well-known and most common is photosensitive epilepsy where certain types of flashing lights can cause a seizure. About 5 in every 100 people who have epilepsy have this type.

But actually, reflex epilepsy is very diverse. Some people will have seizures triggered by certain smells, or certain patterns, or certain emotions, or certain tunes, or even doing certain sort of problem-solving – like mental calculation.

Some of the early cases of computer-triggered epilepsy were caused by certain flash sequences in games, which are now not included by common consent.

Occasionally video-game linked seizures do still appear though, but largely because the game happens to have a characteristic which coincides with the trigger of someone’s pre-existing reflex epilepsy. Maybe a specific sequence of musical notes, or a certain pattern, or even causing a specific feeling of frustration.

But sadly, neither ‘Dark Warrior epilepsy’ nor ‘electronic space war video game epilepsy’ caught on and the medical literature now largely talks about ‘video game-induced seizures’.
 

Link to 1982 case of Dark Warrior epilepsy.