How a game of sudoku helped doctors diagnose a 25-year-old man's bizarre ailment
The puzzle helped doctors diagnose a condition even the MRI scans failed to show
A 25-year-old German man didn’t know that an ordinary ski trip would bar him from playing his favorite puzzle game: Sudoku. In November 2008, he was trapped in an avalanche and buried under snow for 15 minutes, causing oxygen deprivation that damaged parts of his brain. After his friend gave him CPR and he recovered in the hospital, everything seemed fine—until he tried to play Sudoku. The puzzle triggered seizures, helping doctors diagnose a disease that even the MRI scans failed to show. Neurologist Dr. Berend Feddersen documented his special case in the journal JAMA Neurology.
A bizarre diagnosis
After the man's body was deprived of oxygen for a period of time during the avalanche, his brain developed a condition called hypoxia, according to Live Science. Hypoxia provoked a movement disorder in the man, causing uncontrollable twitching in his leg and mouth muscles when he walked or talked. What's surprising is that he didn’t have these twitches in the arms. While he was recovering at a rehabilitation center, he spent his time playing Sudoku, his favorite pastime. That’s when the concerning diagnosis came to light in December 2015.
A suspense that Sudoku revealed
A closer investigation using diffusion tensor imaging, a type of MRI, revealed a lack of “inhibitory fibers” in his brain, which were causing the seizures. Dr. Jacqueline French, professor of neurology at NYU Langone School of Medicine, called this “reflex epilepsy,” according to NBC News. He didn’t experience this epilepsy while writing, reading, or calculating, but during the visual-motor tasks, such as playing chess or cards, were involved.
Sudoku fortifies our focus, but at what cost?
According to a study published in Neurology, around four to seven percent of patients with epilepsy experience reflex seizures. This is even though Sudoku is known for easing anxiety and stress in a person, also helping them have a stronger focus. Research published in the International Urology and Nephrology reported that a 4-week, 12-session Sudoku intervention improved memory and reduced the anxiety scores from 82.71 to 70.93. The reason, as Feddersen explained, lies in the science of how the brain works when a person plays Sudoku.
"In order to solve a Sudoku, the patient used regions of his brain which are responsible for visual-spatial tasks. But exactly those brain parts had been damaged in the accident, which then caused the seizures once they were used. […] The three-dimensional image the patient imagined while solving Sudoku triggered the seizures,” Feddersen explained. Moving on, doctors prescribed anti-epileptic medication to the patient, which stopped his seizures at least for five years. He also had to give up on playing Sudoku. "Fortunately, he can do crossword puzzles. He never had problems with those," Feddersen said.
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