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It seems absurd, but from the Wikipedia article on Photosensitive Epilepsy:

Some PSE patients, especially children, may exhibit an uncontrollable fascination with television images that trigger seizures, to such an extent that it may be necessary to physically keep them away from television sets. Some patients (particularly those with cognitive impairments, although most PSE patients have no such impairments) self-induce seizures by waving their fingers in front of their eyes in front of bright light or by other means.

Wikipedia fails to give a citation as to the existence or commonality of this, but it still strikes me as odd.

Have any studies (case studies or preferably experimental results) validated that some PSE patients want or enjoy seizures? Is there some attraction to the causes of these seizures in the patients that causes this behavior?

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up vote 7 down vote accepted

The article I found goes into the general phenomenon of seizure self-induction, but does spend quite a bit of time on photosensitive epilepsy (PSE). It's a review, so there are plenty of references.

It first points out the prevalence of PSE, which occurs in between 2-5% of the population, and approximately 25% of those affected by the disorder are thought to self-stimulate.

The article supports the assertion on Wikipedia that developmentally challenged and "learning disabled" children are most prone to these self-inductive behaviors, but states that children of normal intelligence and higher may have developed strategies to avoid getting caught doing so during recorded sessions. It does not go into much depth regarding adults self-inducing, but tacitly assumes that adults of normal intelligence would be more likely to understand the harm that a seizure could bring them.

There is support for the notion that children with television induced seizures do try to seek out televisions for this self-stimulation behavior, but the article cautions that this compulsive behavior may be associated with the seizure activity itself, and not something the patients are consciously doing, many describe it as "irresistable."

The article lists a handful of reasons that are commonly thought to promote self-induction:

  • Compulsion - whether for pleasure seeking or as a result of seizure activity
  • Willful avoidance of stress or boredom
  • Hedonistic motivation - to experience an "aura"/trance or other pleasurable feelings
  • Sense of control - so they can have a "say" over when their seizures occur, and also so that they can reap the benefits of the refractory period
  • Attention seeking - being the "sick patient" for sympathetic family members
  • Self-treatment - the patient can give themselves a dose of "convulsive therapy" at will, if this gives them therapeutic relief of concomitant disorders

Stronger doses of anticonvulsant medications, medications to quell any pleasurable reinforcement gained from inducing seizures, specialized contact lenses or glasses to block more light (in the case of PSE), and general behavioral modification strategies are all treatment approaches that can be used. Emphasis is given to knowing when children are self-inducing and involving a psychiatrist in the loop of neurological and pediatric care.

Ng, B-Y (2002) Psychiatric aspects of self-induced epileptic seizures. Australian and New Zealand Journal of Psychiatry,36:534–543.

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