By Vaudine England
BBC News, Hong Kong
A study by doctors in Hong Kong has concluded that epilepsy can be induced by the Chinese tile game of mahjong.
The study said the syndrome affects more men than women
The findings, published in the Hong Kong Medical Journal, are based on 23 cases of people who suffered mahjong-induced seizures.
The report's four authors, from Hong Kong's Queen Mary Hospital, said the best prevention - and cure - was to avoid playing mahjong.
The study led the doctors to define mahjong epilepsy as a unique syndrome.
Epileptic seizures can be provoked by a wide variety of triggers, but one cause increasingly evident to researchers is the playing - or even watching - of mahjong.
This Chinese tile game, played by four people around a table, can involve gambling and quickly becomes compulsive.
The game, which is intensely social and is sometimes played in crowded mahjong parlours, involves the rapid movement of tiles in marathon sessions.
The doctors conclude that the syndrome affects far more men than women; that their average age is 54; and that it can hit sufferers anywhere between one to 11 hours into a mahjong game.
They say the attacks are not just caused by sleep deprivation or gambling stress.
Mahjong is cognitively demanding, drawing on memory, fast calculations, concentration, reasoning and sequencing.
The distinctive design of mahjong tiles, and the sound of the tiles crashing onto the table, may contribute to the syndrome.
The propensity of Chinese people to play mahjong also deserves further study, the doctors say.
What is certain though, is that the only sure way to avoid mahjong epilepsy, is to avoid mahjong which, for many people, is easier said than done.