• epilepsy
• sudden death

For many people with epilepsy and their carers, the unpredictability of seizures is especially stressful and debilitating, limiting normal social function, including employment. It is also a major cause of morbidity and mortality. Sudden unexpected death in epilepsy (SUDEP) is a particular risk; eliminating sleep-related tonic-clonic seizures and lone sleeping might remove 82% of SUDEP risk.1 Moreover, half of all seizures currently remain undetected, though this figure varies significantly between individuals.2

Seizure detection systems build confidence and a sense of control for those with epilepsy and their carers who find these devices helpful3 and early detection may reduce adverse outcomes.4 However, being monitored is not always comfortable; the device may impact on individuals’ independence and relationships. Consent issues arise when considering those with epilepsy who may lack capacity; those with the most refractory epilepsy may find the devices most difficult.5 If these devices prove useful, the clinical community will need to keep track of them, in order to give advice. This may best be done through epilepsy charities, for example, Epilepsy Action who already list these devices but do not provide advice.6

Two broad paradigms may aid risk reduction.

Seizure prediction is where a device …