A Single-center Analysis of Three Japanese Patients with Mahjong-related Seizures

Intern Med. 2023 Apr 15;62(8):1227-1230. doi: 10.2169/internalmedicine.9798-22. Epub 2022 Sep 13.

Abstract

Mahjong is one of the most popular Chinese tile games played in Japan. Mahjong-related seizures (MRS) are rare praxis-induced seizures. We identified three patients with MRS from February 2000 to February 2021. All cases were men, with a middle-age onset, generalized convulsive seizures, and lack of non-provoked, myoclonic, and absence seizures. All patients had no or non-specific neuroimaging or electroencephalogram abnormalities. They did not have features linked to idiopathic generalized epilepsy. All patients were seizure-free after behavioral adjustments, although one patient required anti-seizure medication and avoided long duration games. These changes may help other patients with MRS continue playing Mahjong.

Keywords: Mahjong; Mahjong-related seizure; praxis-induced seizure; reflex epilepsy.

MeSH terms

  • East Asian People
  • Electroencephalography
  • Epilepsy, Generalized* / diagnosis
  • Epilepsy, Generalized* / drug therapy
  • Epilepsy, Generalized* / etiology
  • Female
  • Games, Recreational* / injuries
  • Games, Recreational* / psychology
  • Humans
  • Japan
  • Male
  • Middle Aged
  • Seizures / etiology
  • Time Factors