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They say it’s never too late…4 years later (and many call nights later) back to writing (hopefully!)

As a critical care provider, with a background in epilepsy & seizures, and an avid follower of technology I saw something unique on one of my favorite tech sites -, written by Megan Farokhmanesh. I am also a strong proponent of epilepsy awareness through my work with the NORSE Institute and felt the need to write about this.

It turns out that a group of players using VR chat noted that one member of the virtual group was having a seizure. Kudos to the group and YouTuber Rogue Shadow VR for noticing this fairly quickly as it started occurring. It also turns out that the player was wearing more than the usual VR gear, which allowed for whole-body tracking. This, in part, is what alerted the other players that this member of the chat had collapsed.

The challenge was that none of the players were able to notify the user’s friends/family or place a 911 call - many of them were expressing concern and wanting to help. As one of the players on the VR Chat noted, these episodes can be self-limiting. However at times there can be cardiopulmonary compromise caused by either loss of the airway due to emesis/secretions in the post-ictal period (with decreased level of alertness) and also due to the cardiac consequences of a prolonged seizure (such as severe bradycardia, and others). In this case the player is likely young and without other co-morbidities, however the situation could be very different at other times. Moreover, given that this individual likely has epilepsy, there is a risk that this seizure would be prolonged or reoccur in a condition called status epilepitcus.

This event raises a number of issues:

  • Greater awareness of epilepsy - please visit and other societies such as Epilepsy Canada, Epilepsy Ontario, and also the Epilepsy Foundation

  • Greater knowledge and awareness of Photic- and pattern-induced seizures, for a scientific review see Fisher RS et al., and for a more lay audience, Epilepsy Ontario has some good information.

  • As pointed out by the YouTuber Rogue Shadow VR, not only do users need to be more aware of this risk in VR for visual stimulus-induced seizures, for those with epilepsy, but so do the manufactures of VR gear. There might be a tech solution here with altered patterns, refresh rates, or other parameters.

  • Lastly, it would be great if platforms such as VR Chat, had a mechanism of accessing emergency services for users that may have a medical emergency while in VR. This could start by users, when they sign-up, to have on their account emergency contact information, and list of medical conditions (they are willing to disclose to the platform Only!) - such that in the event of an on-line emergency in VR, other users could ask for a moderator to join the chat and observe that is going on and then trigger the appropriate action. Of course this comes with a hornet’s nest of medical-legal implications for several of the involved parties - however, there is something to be said about safety and accountability as more activity is conducted online and a broader audience may be witness to a medical emergency.

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