Sound Design for Visualising Epilepsy

The following sound design was undertaken gratis for a student at UAL, Kezia Hessam, to help realise a project that is important to her. It was great to be able to work with a perceptive and talented student working their way through the establishment that helped me cultivate and develop my own understanding about sound art and sound design practices within film.

Self Assessment of Sound Design for Visualising Epilepsy

The purpose of this short film, entitled “Visualising Epilepsy”, is to provide the public with information about a proposed VR project that will allow people who do not have epilepsy to better understand what it might be like for those who live with it. (Hessam, 2019)

This film draws on extensive research and the personal experiences of Kezia Hessam, the project’s creator and director. By employing a compilation of brief scenes that depict what it might be like to experience “the visual auras that people with photo sensitivity epilepsy have experienced during an episode” (Hessam, 2019), it allows a viewer to get a good idea of what it might be like to experience a seizure.

For the sound design brief, Kezia provided some background reading about other types of epilepsy, such as musicogenic epilepsy (where music triggers seizures) and autosomal dominant partial epilepsy that is “characterized by sound-related (auditory) symptoms such as buzzing, humming, or ringing.” (Epilepsy Ontario, 2011; Hessam, 2019/a; Hessam, 2019/b; Genetics Home Reference, 2020, p. 1)

The references proved to be invaluable for gaining a better understanding about how to approach this project. For example, with ‘autosomal dominant partial epilepsy with auditory features’ (ADPEAF), one can experience complex sounds during a seizure, such as voices, music or changes in the perceived loudness of sounds i.e. in most cases they tend to be unnaturally elevated. (Genetics Home Reference, 2020) On Epilepsy Ontario’s webpage about ‘Musicogenic Seizures’, one particular patient (named Thomas) mentions that their seizures are brought on by techno music. (Epilepsy Ontario, 2011)

Further to these ideas, the UK’s National Health Service (2017) states:

“Epilepsy is a common condition that affects the brain and causes frequent seizures. Seizures are bursts of electrical activity in the brain that temporarily affect how it works. They can cause a wide range of symptoms.”

From the above, it would seem sound can and does play an important role in certain types of epilepsy and, therefore, could be used to enhance and complement the visuals in this film. For example, the use of electronic sounds (synthesized) might serve as a potent metaphor for the bursts of electrical activity in the brain that occur during a seizure. (National Health Service, 2017)

A rough draft of sound design ideas was presented to Kezia in order to get the creative ball rolling. (2019, Richard)

The first part of the footage from the final cut version of the film (between 00:00:08:00 and 00:00:13:06) contains a disclaimer and the title. Over the title hovers an image of pulsing coloured light, resembling a visual artifact similar to what might be experienced during a photo sensitive seizure. Doing some research, a colleague who has epilepsy mentioned that, before a seizure, their vision was usually disturbed by colours and they became more aware of the sound of their heart beating. (Smith, 2019) As such, it seemed pertinent to add the sound of a heartbeat here to accompany the visual cue. A high-pitched ‘ringing’ tone was also added, offset to one side, to reflect how sound can sometimes manifest off-center during a seizure. (Genetics Home Reference, 2020; Hessam, 2019)

The next scenes (between 00:00:14:06 and 00:00:33:07) shows a woman and man in a non-descript space investigating their surroundings and then donning a VR headset. For this part, a stereo field recording of an empty London café during the evening was used as the background room-tone. The low rumble of air moving around the building via ducting created a spacious empty tone. Additionally, a synth line was added over the room-tone to create a feeling of curiosity and suspense, which develops till the footage cuts to black. This element was created using a the Arturia CS-80V plugin. (Reid & Magnus, 2005)

Once the subjects’ headsets are on, we are presented with a similar pulsing image to the one found over the title of the film (between 00:00:33:10 and 00:00:41:14). However, this time it is projected over the body of one of the subjects. The feeling evoked from this visual was one of isolation and detachment from the usual external outside-world sensory inputs. Thus, the sound of a real heartbeat (captured using contact microphones placed upon a human body) was accentuated and synchronized to the flickering light. This was also mixed with a high-pitched ringing noise and breathing, to create a personal experience of how one’s own bodily mechanisms and functions might sound. In a way, this is a nod to John Cage’s experience inside an anechoic chamber: the two continuous sounds he heard were the high pitch of his central nervous system and the low rumble of his cardiovascular system. (Toop, 1995, p. 140)

Between 00:00:41:15 and 00:00:48:22, lines of light are shone over the body of one of the subjects, providing a slightly clearer, though equally dreamlike, image. Here it seemed important to bring into focus the sound of the heartbeat, making it more recognizable, and give more prominence to the sound of the breath (alluded to by the lines resembling isobars on weather charts, causing movements of air between pressure gradients). As a background to these sounds, a pitched-down piano with a heavy reverb effect was used to simulate a feeling of torpor.

The line hallucination sequence is quickly followed by a clock face, similar to that of Big Ben, projected over the woman wearing a VR headset (from 00:00:48:23 onwards). It seemed important to introduce this new theme with a sound that worked with the imagery. Underneath a bell chiming, a pitched and reversed recording of a ‘ticking’ clock is used, which fades in to a distorted, mechanical ticking, much like someone with ADPEAF might experience during a seizure, where commonplace sounds can become unnaturally loud and distorted. (Genetics Home Reference, 2020, p. 1) This clock hallucination sequence is broken up briefly by a rush of imagery interspersing it. After several attempts at creating a sonic arrangement for this brief flutter, Kezia asked for a scratchy type of sound, which was compiled using various samples of white-noise-like sounds from various recordings, underlined with a low frequency tone. (Hessam, K. 2019/c) After this rush of imagery, one sees the woman looking on, this time without her VR headset. At this point it seemed important to place a breath here, as if the hallucinations are starting to obtrude and what is real becomes blurred with the imagined.

From 00:01:00:00 to 00:01:21:07, the footage becomes quite abstract. The man and woman (sometimes pictured wearing their VR headsets and sometimes not) have lines of coloured light projected over them. Here there are no particular discernable shapes or links to the outside world i.e. nothing in the patterns of light can be recognized. As such, Kezia suggested the use of a Shepard-Risset Glissando tone, similar to those used throughout “Dunkirk” (2017), to create a sense of disorientation and an ever-building sense of tension to all-the-more blur the line between illusion and reality. (Hessam, 2019/c) Interestingly, the Shepard-Risset glissando has been known to induce strong vection experiences, creating the illusion of movement when one is stationary. (Mursic et al., 2017) Furthermore, this particular sequence in the film is not only layered with beats (designed to sound like a racing heartbeat), but utilizes pitched contact microphone recordings of taut cables (from 00:01:15:00 onwards) to instill the notion of tension.

At 00:01:21:08 (to 00:01:25:08) a transition in the moving image occurs, as the man (wearing a VR headset) gives way to the woman without a VR headset. It felt important to remove the rhythm at this point and utilize an echo effect to simulate a throbbing heartbeat, contriving another aural hallucination.

After 00:01:25:08, one is presented with a sequence of images that are not particularly threatening or familiar. Here it seems as if the woman might almost be amused by the novelty of what she is witnessing. As noted earlier, some people’s seizures are brought about by techno music. (Epilepsy Ontario, 2011) Thus, a nondescript techno type arrangement was added to the rhythm between 00:01:25:09 and 00:01:32:23.

The visuals become slightly more pronounced and intense between 00:01:33:00 and 00:01:35:01. Here we see the man with a VR headset looking up with open hands, almost like he is begging. Here it seemed pertinent to utilize a change in sound to emphasis the intensity of fluxing colours. Thus a modulated bass frequency was used here. At 00:01:35:02 we see the woman clasping her arm in a shielding and protective gesture, as if this experience is becoming a bit much to bear. Here a pulse of sound is used to highlight how their experiences are becoming uncomfortable.

The scenes now chop-and-change more frequently from 00:01:35:02 onwards, cutting between close-up shots of the subjects’ faces, to pulled back views of their torso and body. These edits add tension and, with the strobing patterns of coloured light projected over the subjects, it felt as if there was a parallel between the visuals used in the film “2001: A Space Odyssey” (1968, 1 hour 57 mins). Vocal tones similar to György Ligeti’s “Requiem For Soprano, Mezzo-Soprano, Two Mixed Choirs & Orchestra” (2018) were used between 00:01:37:00 and 00:01:45:00 to evoke a sense of disorientation and fear. To maintain continuity with this vocal theme, the voices are treated (pitched and heavily effected by granular synthesis) later on to develop the uncomfortable feeling and complement the kaleidoscopic projections of fractal patterns (00:01:49:19 and 00:01:51:11).

Furthermore, Kezia asked for some white-noise to be included in these final sequences. (Hessam, 2019/d) While the direct addition of white noise did not complement the rest of the mix, notch-filtered frequencies of white-noise with added distortion seemed to work well and were added between 00:01:47:00 to 00:01:47:06 and 00:01:48:07 to 00:01:48:21 so as to suggest how the experience of the seizure is becoming unpleasant and overbearing.

We are left at the end with an image of the woman wearing her VR headset with lines of light projected over her face (at 00:01:57:03). However, at 00:01:58:15 the headset flickers and vanishes altogether, implying that this experience for those with epilepsy is not just something one can remove (like a VR headset) but is a very real aspect of their daily lives. In order to add gravitas to this point in the imagery, it was suggested that a “boom effect” might better represent the way the headset flickers away into a reality. (Hessam, 2019/d)

For the sound accompanying the information presented at the end of the film (00:02:07:00 onwards), Kezia requested that something “creepier” be created. (Hessam, 2020) Given the strong preference for low frequency type sounds within this project, a low rumbling sonic texture (taken directly from the Omnisphere 2 sound library) was used to bring into focus the uncomfortable undertone to the reality this VR experience addresses. As the individual points fade in, so they are heralded by separate discordant notes, done as a way to underline each of the facts.

Overall it has been a rewarding project to work on. Probably the most challenging aspect was composing a rhythm that would suit the imagery and fit between the timings of the visual cuts and cues. Also, various sonic elements were continually revised throughout the creation of this sound design project, which meant that other elements had to be readjusted in the mix so that they complemented the overall flow. Aside from these challenges, it provided a unique opportunity to understand more about what people with epilepsy go through, how their seizures can be triggered in different ways, and what to do when someone has a seizure.


Dunkirk (2017). Directed by Christopher Nolan [Film]. U.K.: Warner Brothers. Available at: [Accessed: 29th November 2019]

EPILEPSY ONTARIO (2011) Musicogenic Seizures, 8th August. Available at: [Accessed: 29th November 2019]

GENETICS HOME REFERENCE (2020) Autosomal dominant partial epilepsy with auditory features, 7th January. Available at: [Accessed: 13th January 2020]

GYÖRGY LIGETI, BAVARIAN RADIO SYMPHONY ORCHESTRA & FRANCIS TRAVIS (2018) Requiem For Soprano, Mezzo-Soprano, Two Mixed Choirs & Orchestra [mp3]. Turner Entertainment Co. and Warner Bros. Entertainment Inc. Available at: [Accessed: 13th January 2020]

HESSAM, K. (2019) Telephone conversation with Karl Richard, 1st December.

HESSAM, K. (2019/a) Email to: Karl Richard, 28th November.

HESSAM, K. (2019/b) Email to: Karl Richard, 30th November.

HESSAM, K. (2019/c) Email to: Karl Richard, 13th December.

HESSAM, K. (2019/d) Email to: Karl Richard, 26th December.

HESSAM, K. (2020) Email to: Karl Richard, 13th January.

MURSIC, R., RIECKE, B., APTHORP, D. & PALMISANO, S. (2017) The Shepard-Risset glissando: music that moves you. Experimental Brain Research, vol. 235 (10), pp.3111-3127. Available at: [Accessed: 14th January 2020]

NATIONAL HEALTH SERVICE (2017) Epilepsy – Overview, rev. 4th September. Available at: [Accessed 14th January 2020]

REID, G. & MAGNUS, N. (2005) Arturia CS80V. Sound On Sound, April. Available at: [Accessed 13th January 2020]

RICHARD, K. (2019) Email to: Kezia Hessam, 30th November.

SMITH, J. (2019) Conversation with Karl Richard. 14th December.

TOOP, D. (1995) Ocean of Sound. London: Serpent’s Tail.

2001: A Space Odyssey (1968) Directed by Stanley Kubrick [Film]. AOL Time Warner Company.

To contact Kezia Hessam, please visit her website here.