Letters

MJA 2000; 173: 671

On questioning, the girl revealed that two cousins were visiting for the summer vacation, and had brought with them a Nintendo 64 (Nintendo Co Ltd, Kyoto, Japan) game, Mario Party. She had never played this game before. On the evening of the day when she had played her first game, lasting two hours, the girl complained to her mother of the hand blister. When asked, the girl admitted that she was so engrossed in the game that she used her palm to press the joystick repeatedly and enthusiastically (see Figure (b)).

Treatment consisted of abstinence from playing the game and applying an antiseptic cream twice daily. The lesion took 14 days to heal, and left a scar.

The Nintendo company has sold more than a billion video games worldwide to date, and since its launch in 1996 Nintendo 64 has proved one of the most popular interactive software games.¹ The realistic images and three-dimensional graphics are so captivating that players often spend many hours glued to the game. There have been reports of Nintendo playing causing daytime enuresis (three boys aged 3.5, 5 and 7 years),² faecal incontinence (a 6-year-old),³ epilepsy (a 13-year-old)⁴ and soreness of the right thumb ("nintendinitis" in a 35-year-old).⁵ All these patients were noted to be deeply engrossed in the interactive games and their pathologies all resolved following abstinence from playing. We believe that this is the first reported case of hand ulceration caused by playing Nintendo 64.

The multilingual consumer information booklet for Nintendo 64 carries a warning of the risks of epilepsy, repetitive strain injury and motion sickness. The parents of our patient had not read the leaflet and were unaware of these potential complications. Parents should warn their children not to use too much force during games and should limit duration of play.

We recommend that any medical practitioner who sees a patient with an unusual hand injury, epilepsy or motion sickness should ask, "Do you play any interactive computer games?". Indeed, we recently encountered a child with diabetes who spent so much time playing these interactive games that lack of exercise resulted in abnormally raised blood glucose levels.

T H H Guan Koh
Senior Neonatal Paediatrician, Department of Neonatology
Kirwan Hospital for Women
PO Box 187, Thuringowa, QLD 4817
kohtAThealth.qld.gov.au

1. Nintendo home page <http://www.nintendo.com/corp/ history.html (accessed October 1999).
2. Schink JC. Nintendo enuresis. Am J Dis Child 1991; 145: 1094.
3. Corkery JC. Nintendo power. Am J Dis Child 1990; 144: 95-99.
4. Hart EL. Nintendo epilepsy [letter]. N Engl J Med 1990; 322: 1473.
5. Brasington R. Nintendinitis [letter]. N Engl J Med 1990; 322: 1473-1474.

©MJA 2000
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