Nature Blog Network

Friday, August 31, 2007

Mahjong Induces Seizures!

Disclaimer: This has absolutely nothing to do with invertebrates, except for spineless players who chow everything to get the quicky and dirty mahjong. There's no glory in low scores!

Mahjong indoctrination starts early in China.

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.

Click on table to display larger version.

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!


  1. I love mah jong but can barely score, much less gamble.
    Hats off to you for exposing this hazards of the fast-paced MJ lifestyle. I'll have to tell my grandmother.

  2. You are correct in that planning, thinking, and other activities that require deep mental investment put you at risk for mental event like seizures.

    But it's not the thinking that does it. It's doing all that concentrating in a location with repeating detectable movement in peripheral vision.

    The problem is called Subliminal Distraction. It was discovered when it caused mental breaks for office workers. The cubicle was designed to deal with the vision startle reflex and solved the business office problem by 1968.

    Mahjong players who have this problem probably also have exposure somewhere else. An office without cubicles or Qi Gong sessions could do that.

    Qi Gong users who perform too many sessions in a compact time frame have mental events.

    Stopping either the Mahjong or a second activity with SD exposure will stop the seizures.

    I believe that SD is causing the sudden unexplained disappearances and suicides of college students.

    Tell you associates and send them to VisionAndPsychosis.Net.


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