• Keita Umetani, Takashi Matsudaira, Naotaka Usui, Kentaro Tokumoto, Rie Motoyama, Norihiko Kawaguchi, Yasukiyo Araki, Akihiko Kondo, Takuji Nishida, Hitoshi Ikeda, and Yukitoshi Takahashi.
• National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorders, Japan.
• Intern. Med. 2023 Apr 15; 62 (8): 122712301227-1230.

AbstractMahjong 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.

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