Background: The pathogenesis of card game-induced reflex epilepsy has not been determined so far. The aim of this study was to evaluate structural abnormalities using voxel-based morphometry (VBM) analysis, which may give some clue about the pathogenesis in card game-induced reflex epilepsy. Methods: The 3 subjects were diagnosed with card game-induced reflex epilepsy. Evaluation involved a structured interview to obtain clinical information and brain MRI. In VBM analysis, Statistical Parametric Mapping 8 running on the MATLAB platform was employed to analyze the structural differences between patients with card game-induced reflex epilepsy and age- and sex-matched control subjects. Results: The results of VBM analysis revealed that patients with card game-induced reflex epilepsy had significantly increased gray matter volume in the right occipital and parietal lobe. However, there were no structures with decreased gray matter volume in patients with card game-induced reflex epilepsy compared with control subjects. In addition, we found that the patients with card game-induced reflex epilepsy had onset of seizures in adulthood rather than in adolescence, and all of the patients were men. Conclusions: The parieto-occipital lobes might be partially involved in the neuronal network responsible for card game-induced reflex epilepsy.

1.
Koepp MJ, Caciagli L, Pressler RM, Lehnertz K, Beniczky S: Reflex seizures, traits, and epilepsies: from physiology to pathology. Lancet Neurol 2016;15:92-105.
2.
Lee SA, Choi EJ, Kang JK: Reflex epilepsy induced by playing oriental card or board games. J Clin Neurol 2006;2:262-267.
3.
Striano S, Orsini A, Vitolo S: ‘Epilepsia arithmetices'. Clinical and EEG study of a case and characteristics of precipitating factors. Acta Neurol (Napoli) 1983;5:14-19.
4.
Brenner RP, Seelinger DF: Drawing-induced seizures. Arch Neurol 1979;36:515-516.
5.
Ohtaka T, Miyasaka M: [A case of language-induced epilepsy precipitated mainly by writing (author's transl)]. Seishin Shinkeigaku Zasshi 1977;79:587-601.
6.
Forster FM, Richards JF, Panitch HS, Huisman RE, Paulsen RE: Reflex epilepsy evoked by decision making. Arch Neurol 1975;32:54-56.
7.
Wilkins AJ, Zifkin B, Andermann F, McGovern E: Seizures induced by thinking. Ann Neurol 1982;11:608-612.
8.
Fisher RS, Acevedo C, Arzimanoglou A, Bogacz A, Cross JH, Elger CE, Engel J Jr, Forsgren L, French JA, Glynn M, Hesdorffer DC, Lee BI, Mathern GW, Moshé SL, Perucca E, Scheffer IE, Tomson T, Watanabe M, Wiebe S: ILAE official report: a practical clinical definition of epilepsy. Epilepsia 2014;55:475-482.
9.
An D, Zou X, Chen T, Yan B, Liu L, Zhou D: Clinical characteristics and prognosis of mah-jong-induced epilepsy: a cohort review of 56 patients. Epilepsy Behav 2015;53:117-119.
10.
Lee MK, Yoo J, Cho YJ, Lee BI, Heo K: Reflex epilepsy induced by playing Go-stop or Baduk games. Seizure 2012;21:770-774.
11.
Frisoni GB, Fox NC, Jack CR Jr, Scheltens P, Thompson PM: The clinical use of structural MRI in Alzheimer disease. Nat Rev Neurol 2010;6:67-77.
12.
Ashburner J, Friston KJ: Voxel-based morphometry - the methods. Neuroimage 2000;11(6 pt 1):805-821.
13.
Ashburner J, Friston KJ: Why voxel-based morphometry should be used. Neuroimage 2001;14:1238-1243.
14.
Särkämö T, Ripollés P, Vepsäläinen H, Autti T, Silvennoinen HM, Salli E, Laitinen S, Forsblom A, Soinila S, Rodríguez-Fornells A: Structural changes induced by daily music listening in the recovering brain after middle cerebral artery stroke: a voxel-based morphometry study. Front Hum Neurosci 2014;8:245.
15.
Pope RA, Centeno M, Flügel D, Symms MR, Koepp M, Thompson PJ, Foong J: Neural correlates of de novo depression following left temporal lobe epilepsy surgery: a voxel based morphometry study of pre-surgical structural MRI. Epilepsy Res 2014;108:517-525.
16.
Muñoz-Ruiz MÁ, Hartikainen P, Koikkalainen J, Wolz R, Julkunen V, Niskanen E, Herukka SK, Kivipelto M, Vanninen R, Rueckert D, Liu Y, Lötjönen J, Soininen H: Structural MRI in frontotemporal dementia: comparisons between hippocampal volumetry, tensor-based morphometry and voxel-based morphometry. PLoS One 2012;7:e52531.
17.
Summerfield C, Junqué C, Tolosa E, Salgado-Pineda P, Gómez-Ansón B, Martí MJ, Pastor P, Ramírez-Ruíz B, Mercader J: Structural brain changes in Parkinson disease with dementia: a voxel-based morphometry study. Arch Neurol 2005;62:281-285.
18.
Ferlazzo E, Zifkin BG, Andermann E, Andermann F: Cortical triggers in generalized reflex seizures and epilepsies. Brain 2005;128(pt 4):700-710.
19.
Zhao C, Teng EM, Summers RG Jr, Ming GL, Gage FH: Distinct morphological stages of dentate granule neuron maturation in the adult mouse hippocampus. J Neurosci 2006;26:3-11.
20.
Fumuro T, Matsumoto R, Shimotake A, Matsuhashi M, Inouchi M, Urayama S, Sawamoto N, Fukuyama H, Takahashi R, Ikeda A: Network hyperexcitability in a patient with partial reading epilepsy: converging evidence from magnetoencephalography, diffusion tractography, and functional magnetic resonance imaging. Clin Neurophysiol 2015;126:675-681.
21.
Salek-Haddadi A, Mayer T, Hamandi K, Symms M, Josephs O, Fluegel D, Woermann F, Richardson MP, Noppeney U, Wolf P, Koepp MJ: Imaging seizure activity: a combined EEG/EMG-fMRI study in reading epilepsy. Epilepsia 2009;50:256-264.
22.
Irmen F, Wehner T, Lemieux L: Do reflex seizures and spontaneous seizures form a continuum? - triggering factors and possible common mechanisms. Seizure 2015;25:72-79.
23.
Anzellotti F, Franciotti R, Onofrj M: Temporal recruitment of cortical network involved in reading epilepsy with paroxysmal alexia: a combined EEG/MEG study. Seizure 2013;22:156-158.
24.
Hizem Y, Gargouri A, Ben Djebara M, Kacem I, Abdelkefi I, Jemli F, Gouider R: Hot water epilepsy with pachygyria. Neurol Sci 2012;33:631-633.
25.
Magara S, Kawashima H, Kobayashi Y, Akasaka N, Yamazaki S, Tohyama J: Rub epilepsy in an infant with Turner syndrome. Brain Dev 2015;37:725-728.
26.
D'Souza WJ, O'Brien TJ, Murphy M, Trost NM, Cook MJ: Toothbrushing-induced epilepsy with structural lesions in the primary somatosensory area. Neurology 2007;68:769-771.
27.
Goossens LA, Andermann F, Andermann E, Remillard GM: Reflex seizures induced by calculation, card or board games, and spatial tasks: a review of 25 patients and delineation of the epileptic syndrome. Neurology 1990;40:1171-1176.
28.
Naquet R, Menini C, Riche D, Silva-Barrat C, Valin A: Photic epilepsy problems raised in man and animals. Ital J Neurol Sci 1987;8:437-447.
29.
Aydin-Ozemir Z, Terzibasioglu E, Altindag E, Sencer S, Baykan B: Magnetic resonance spectroscopy findings in photosensitive idiopathic generalized epilepsy. Clin EEG Neurosci 2010;41:42-49.
30.
Italiano D, Ferlazzo E, Gasparini S, Spina E, Mondello S, Labate A, Gambardella A, Aguglia U: Generalized versus partial reflex seizures: a review. Seizure 2014;23:512-520.
31.
Oller-Daurella L, Sorel L: [Benign grand mal epilepsy in the adult]. Acta Neurol Belg 1989;89:38-45.
32.
Rakic P, Bourgeois JP, Goldman-Rakic PS: Synaptic development of the cerebral cortex: implications for learning, memory, and mental illness. Prog Brain Res 1994;102:227-243.
33.
Fair DA, Dosenbach NU, Church JA, Cohen AL, Brahmbhatt S, Miezin FM, Barch DM, Raichle ME, Petersen SE, Schlaggar BL: Development of distinct control networks through segregation and integration. Proc Natl Acad Sci U S A 2007;104:13507-13512.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.