When 150 children, 84 with epilepsy, were exposed to 15 minutes of three-dimensional TV, no seizures occurred—but some important EEG changes were observed.

BALTIMORE—Preliminary results from an ongoing study indicate that three-dimensional (3D) TV does not pose a significant safety hazard for children with epilepsy, researchers reported at the 65th Annual Meeting of the American Epilepsy Society.

The risk of suffering a seizure by watching 3D TV is very low, but not zero, and we think that it’s probably basically linked not to the 3D technique itself but to the content of the video,” said study coauthor Gerhard Kluger, MD, of Schön Klinik, Vogtareuth, Germany, and Paracelsus Medical University, Salzburg, Austria.

Although the electronics manufacturer Samsung has warned consumers that 3D TV may cause epileptic seizures, no previous research has investigated this possibility in children, especially in children with epilepsy, Dr. Kluger said. His study team, together with Herbert Plischke, MD, Managing Director of the Generation Research Program at the University of Munich, and other researchers, are doing so through a study that will eventually include at least 200 children with the condition.

The researchers are providing each study participant with two EEGs—a 20-minute, routine EEG that includes photo stimulation, and an EEG performed while the participant views 15 minutes of 3D video footage from the film Ice Age 3. Participants view this footage on a 50-inch 3D plasma TV while sitting about 2 meters away and wearing 3D shutter glasses.

The researchers have compiled data on 150 children and adolescents—84 with epilepsy and 66 with other neurologic conditions, such as headache, that suggested the risk of epilepsy. Participants had a mean age of 12, and 77 (51%) were male.

“We did not observe a single patient suffering a seizure during the 15 minutes” of 3D viewing, Dr. Kluger said. However, one participant with epilepsy, who typically experiences seizures four times per day, had a seizure two minutes following the viewing. “We cannot be sure it was linked to the 3D viewing, but we cannot exclude that a longer observation period might cause harm,” said Dr. Kluger.

In addition, three participants—all of whom were between the ages of 14 and 16 and had idiopathic generalized epilepsy—experienced a paroxysm increase of more than 100% during the 3D viewing. None of these adolescents made any complaints, showed any clinical signs, or experienced any subclinical seizures during the viewing.

“Interestingly, one boy with the diagnosis of ADHD (under treatment with methylphenidate) without a history of seizures showed a normal routine EEG with no epileptiform spikes but some spike during 3D viewing,” Dr. Kluger told Neurology Reviews.

It is likely that the observed paroxysm increases were triggered by non-3D content of the film, such as surprises and motion, according to Dr. Kluger. Laboratory time constraints necessitated the 15-minute period for 3D viewing and prevented researchers from comparing children’s reactions to 3D TV with their reactions to normal TV, he added. The study team is planning to perform research with a longer 3D viewing period and different video material in the future.

Most participants experienced a significant increase in lambda waves during the viewing period. The researchers attributed this increase to normal augmentation of saccadic eye movements.

Although 15 children with no history of seizures were photosensitive, as indicated by photoparoxysmal reactions during the pre-viewing EEG, no child showed any paroxysmal increase while viewing 3D. “3D seems to be no special problem for this population—at least with the 3D technology and the method we have used so far,” Dr. Kluger said.

In 10 patients with epilepsy, there was a reduction in the frequency of epileptiform activity during the 3D viewing. “This is not unusual, and it may be easily explained by an increase in alertness” during the viewing, Dr. Kluger noted. “Typically, if a child with epilepsy is alert, then he or she doesn’t seize so often.”

Seventeen percent of the children complained of dizziness, headache, or nausea. “That’s quite a lot,” Dr. Kluger said. “And my impression is that the older the children, the more likely they didn’t like the 3D.

“I think most of the children can go home and go to the video and watch it, but in some there’s doubt,” Dr. Kluger concluded. “Maybe when we study 200 children with epilepsy, we can answer these questions more precisely.”

Apart from the study, Dr. Kluger said, “I think we will continue offering this simulation for the parents, because they go home happy there was no reaction.” He also emphasized, “Children with epilepsy should do the same as children without epilepsy as much as possible.”

—Jack Baney

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