Anyone that knows me outside of the blogosphere, knows I won't turn down a good game of Mahjong. Hat tip to my dutch neighbours (everyones a blogger these days!) and mahjong score keepers (also maker-up of the mysterious special hands that give him 10,000+ yuan each freakin hand) for this strange article. According to Chang et al. 2007,
'Mah-jong epilepsy' is a rare reflex epilepsy syndrome, manifesting as recurrent epileptic seizures triggered by either playing or just watching mah-jong.And what was this epic study based on? (Trumpet sounds) A sample size of 3! Which we all know is the magic number. Each patient had no family history of epilepsy.
Case Study 1: 79 year old male, played mahjong for 8 hours, held a ready hand when onset of a generalised tonic-clonic seizure (GTCS) occurred. Upon admittance, normal neurological exam, EEG and CT. Man had a history of 2 other events while playing mahjong within the last 3 years. Stopped playing mahjong after 3rd seizure and has not had any since (8 years later).
Case Study 2: 42 year old male, seizure while playing mahjong. Normal neurological exam, EEG and CT as well. Abstained from mahjong, resumed playing mahjong after a few years. 3 years after resuming mahjong had 2 seizures while playing (even with resumption of medicine). Quit playing for good, seizure free for last 18 months.
Case Study 3: 39 year old male, seizure onset after 2 hours of playing mahjong. Unremarkable examinations and scans. Avoids mahjong now, no seizures.
The authors note that:
"Reflex seizures associated with mah-jong, brought on by either playing or watching the game, constitute a rare condition not recognised until recently. To date, only 20 cases of ‘mah-jong epilepsy’ (MJE) have been reported in the English literature."The mean age of onset was 54 years, range 34-76 yrs. (n=23), males outnumber females 10:1 and attack frequency ranged from one every 3 years to more than 30 a year (depending on x, y, z).
"Mah-jong is a cognitively demanding game. It involves substantial higher mental processing and outputs: memory, concentration, calculations, reasoning, strategies, sequential thinking and planning, consideration of alternative solutions, and a lot of decision-making. From this perspective, mahjong–induced seizures are best classified as a subtype or manifestation of cognition-induced epilepsy"Wait a second, thinking, calculating and making decisions can make you prone to seizures! Someone better tell my advisor this.
Actually its pretty interesting stuff. Understandably, its pretty rare and I am sure sleep deprivation after playing 10+ hours and stress over losing copious amounts of money contribute greatly. I can see how someone's cognitive system just shuts down or freaks out! Take it easy chinese people! Play with fake money instead and drink plenty of water!