Category: technology

Neurodefender: Video Games and Epilepsy

My first video game console was an Atari 2600 that my sister and I received for Christmas when I was eight.1 It was magical to toggle the switchbox and have an arcade on my television screen. Within a few months, I had a collection of cartridges. Pitfall, Pac-Man, Donkey Kong. I even had that horrible E.T. game. But Space Invaders was my favorite game, and my mother’s boss and I had a friendly competition every time we visited his family.

I usually won.

As I got older, I became very interested in computers. My first computer was a Mattel (yes, that Mattel) Aquarius, one of the shortest-lived computers ever to go to market. It had a Tron game that I played constantly, even though I had never seen the movie. But it was the ability to program on the Aquarius that got me hooked and, for a long time, my world revolved around computers and my gaming followed suit.

My first online games were on a computer. That was back before there were high-powered consoles connected to the internet. I’m talking the days of dial-up modems. I would spend hours playing an air combat game with a classmate, but I was obsessed with the text-based fantasy role playing game Gemstone on GEnie, an early online service. It was a massively multiplayer online role-playing game (MMORPG) that connected people across the country in a virtual world. Eventually, I moved on to more graphical games like the World of Warcraft, but the ability to connect with other people in these worlds was life-changing and even turned into friendships in the real world. One of my groomsmen at my wedding was someone whom I had originally met in an online game.

My son developed a love for video games at an early age. We had a Wii and loved to play baseball and, especially, bowling. I have videos of him running circles around the house after getting a strike, a huge smile on his face emitting an excited giggle.

As he got older, we began to play video games together, especially sport games like hockey. We’d adjust the settings to give him an edge, and I’d occasionally have to pull my goalie and allow him to score to keep the game close, but it was a fun way to spend time together doing something that we both enjoyed.

Eventually, of course, I stopped pulling my goalie and boosting his settings because he got better. Today, he wins more games than me. The grasshopper has become the teacher. And we’ve expanded to other games. We finished the Halo series, one of my all-time favorites. We played MarioKart every night during the pandemic to get three stars on every course. Today, we play Fortnite and Rocket League together, with an occasional session of Minecraft mixed in.

But I’m not the only one he plays with. This era of powerful PCs and consoles with fast internet has opened up the world and allowed him to play with his friends. He has a friend in Connecticut who plays a baseball video game with him. And he hops on Fortnite after school to play with a few of his friends. Through them, he’s met other friends and he has a little network of gamers. Especially over the summer, it’s helped him stay connected as many families travel and it’s been harder to connect with summer schedules.

In this world of gamers streaming on platforms like Twitch, he has decided that it is the career he wants to pursue. Whether or not that is a viable path for him, it has been a great way for him to explore many aspects of a traditional career: schedules, consistency, marketing, and engagement. He learns by watching other streamers and then practices engaging with his audience, describing his actions and thought process as he navigates a challenge. He loves to teach the “noobs”2 how to get started and basic tactics and tips.

As a technologist and a gamer, it’s been fascinating to see how far gaming technology has come. For my son, it’s become a way to connect, express himself, and find his place in a world that hasn’t always made that easy. Watching him game, teach, laugh, and grow through this medium is beyond anything I could have imagined.

If you want to see what he’s building—and maybe learn a thing or two yourself—you can check out his Twitch stream here: @neurodefender.

Game on.

  1. Crazy side note, when the Atari 2600 was introduced, it cost $190, equivalent to paying $990 in 2024! ↩︎
  2. Slang for a newbie—someone who is inexperienced or new to a particular activity, especially in gaming or online communities. ↩︎

The Other AI: Autonomy and Influence

My son has been asking more frequently about living by himself. We’ll have a talk about independence and responsibility, and loosely talk about goals to help him move in that direction. But I also watch as he struggles to remember whether he had taken his medication, or put on deodorant, or pull his sheets up when he makes his bed.

As I watched him try to piece it together, I thought about the technology that I work with and whether it could help him.

I’ve been involved with computers and technology for most of my life, building products with bits and bytes of code and data. For the past ten years, I’ve worked in the evolving field of artificial intelligence (AI).

I recognized early on that AI could potentially transform my son’s life. As the technology matured, I watched it advance the state of medicine and healthcare.

Today, AI algorithms power diagnostic tools, accelerating the time to detect, identify, and treat complex medical conditions. AI is accelerating drug discovery, helping researchers identify promising treatments faster than ever before. It is also being used to examine genetic data to identify the right medication and dosage for individual patients.

AI could improve his quality of life in ways that weren’t possible only a few years ago. Pattern recognition can alert us when he misses a medication or a meal. Personal assistants can provide reminders, keep him on task, and communicate with him in a way that he understands. Self-driving cars will give him mobility and access to a wider world. AI-driven tools can assist him with complex tasks, help him communicate ideas, and give him greater autonomy and independence.

That’s the promise and the potential.

But here’s the problem. We live in a world where AI is already causing harm.

Inherent challenges with the technology, especially with generative AI (e.g., ChatGPT), result in hallucinations where the algorithm makes things up. The black-box nature of these algorithms makes them unpredictable and impossible to test fully, resulting in harmful behavior. And these algorithms are owned by corporations who control the data, usage, and output and can tune it to fit their agenda.

Beyond technology, people have been using these tools for nefarious purposes. It’s easy to create a false but believable story and share it on social media. It’s also easy to create completely believable but fake images and videos to mislead viewers. These bad actors are using the technology to push false narratives and generate mistrust and dissent in society.

My son struggles with memory and executive functioning. It impacts his ability to reason and determine whether what he is reading is fact or opinion, truth or lies. While I think society at large has lost its ability to thing critically, people like my son are especially susceptible to these false narratives and the harm they can cause.

So while I’m building the future with AI, I’m also guarding the present for my son. I want him to have access to all the promise this technology offers — the support, the independence, the chance to live on his own — without falling victim to its dangers. I have to be his guide, his filter, and his advocate.

Because while AI might one day help him remember his medication or build a career, it won’t teach him who to trust, what’s real, or what truly matters. It’s my job to walk beside him, protect him, and help him make sense of a world that’s changing faster than any of us can keep up with.

Yet

“Yet” is such a powerful word.

“Yet” allows us to acknowledge current struggles while leaving space for future possibilities. It’s a bridge between what is and what could be, subtly shifting focus from a fixed state to one of potential.

There have been so many times when we thought we were out of options when it came to treatments for our son’s epilepsy. We tried all the medications. We tried the ketogenic diet. Because his seizures were generalized, he wasn’t a candidate for surgeries that are available to people who have focal seizures.

Each time one of the treatments failed to control his seizures, we felt resigned to give up hope.

But even in the 10 years since my son was diagnosed, there have been many new advancements.

Genetic testing is being used to identify specific genetic mutations associated with epilepsy, which has enabled personalized treatment strategies, improving efficacy and reducing side effects.

Epidiolex was introduced in 2018 to treat Lennox-Gastaut syndrome and Dravet syndrome.

A new surgical technique called Laser Interstitial Thermal Therapy (LITT) that uses a laser to target and ablate seizure-causing brain tissue precisely was approved, reducing recovery time compared to traditional surgery.

Although it was used off-label earlier, Vagus Nerve Stimulation (VNS), which involves implanting a device that stimulates the vagus nerve to reduce seizure frequency, was FDA-approved in 2017 to treat children as young as 4 years old with drug-resistant focal epilepsy.

Deep Brain Stimulation (DBS), traditionally used to treat movement disorders like Parkinson’s, is now being used to target brain regions like the anterior nucleus of the thalamus to reduce seizure frequency in individuals with drug-resistant epilepsy.

We’ve benefited from these advancements. In addition to genetic testing, my son had VNS surgery when he was nine and DBS surgery right before his 15th birthday, even though they weren’t options when our journey started.

Of course, it’s easier to be on this side of it and say that I always had hope or that I automatically added the word “yet” to the sentence “there is nothing left to try.” I didn’t. I was overwhelmed because everything we tried didn’t stop the seizures. I had almost lost my son, and I was afraid that, with every failed treatment, every door was closing on his future.

Eventually, I would be reluctant to try a door because that would mean fewer were available. At least with untested doors, there was hope. It’s like in high school, when there was a girl I liked, if I didn’t ask her out, she couldn’t say “no,” so there was always hope for a “yes.”

What changed for me was seeing the advancements and having them offered. First, there was a new medication, then another, and then the VNS. I saw first-hand how continued progress created more doors, making trying one a little less scary. I began to believe there would be more doors, which made it easier to believe in the word “yet.”

Right now, our hand is on the DBS door. We’ve cracked it open and are waiting to see what is on the other side. There are never guarantees, but we hope it improves our son’s quality of life. If it doesn’t and we have to close that door, too, when the feeling comes back that there is nothing left to try, I will remember to complete the sentence:

It feels like there is nothing left to try…yet.