What is epilepsy?
Epilepsy is a chronic neurological disorder that causes recurrent, unprovoked seizures. These seizures can vary in frequency, severity, and form, affecting cognition, movement, awareness, and mood.
Diagnosing epilepsy accurately is challenging
- Seizures are unpredictable and often unwitnessed
- Symptoms can be subtle, misremembered, or mistaken for other conditions
- Current tools (like office EEGs or seizure diaries) may not capture infrequent events
- Traditional monitoring methods may be too short-term to capture events
- Patient self-reporting can be unreliable or incomplete
Global impact
- Affects over 52 million people worldwide
- Fourth most common neurological disorder
- In the US:
- 3.4 million people affected (3.0M adults, 0.4M children)
- 150,000 new diagnoses annually
- US$24.5B annual healthcare spend
- Healthcare costs rising at 2x overall rate
Health risks
- Mortality risk 3-10x higher than general population
- Risks include vehicle accidents, fractures, burns, drowning
- Status epilepticus can be life-threatening
Quality of life impact
- Psychological effects: Depression, anxiety, learning difficulties
- Social challenges: Employment, relationships
- Impact extends to family and caregivers
- Significant indirect costs through lost productivity
Drug-resistant epilepsy
- Affects 40% of epilepsy patients (~1.2M US adults)
- Defined as failure to achieve seizure freedom after two adequate anti-seizure medication (ASM) trials
- Additional cost of $12,000 per patient annually
- Requires specialised treatment approaches
Understanding epilepsy
Epilepsy affects approximately 52 million people worldwide, making it one of the most common neurological disorders. It is characterized by recurrent seizures, which are brief episodes of involuntary movement that may involve a part of the body (partial) or the entire body (generalized).
Seizures occur due to excessive electrical discharges in a group of brain cells. Different parts of the brain can be the site of such discharges, resulting in various types of seizures with different symptoms.
Types of seizures
Seizures are classified into two main categories:
- Focal seizures (also called partial seizures) - These start in one area of the brain and can occur with or without loss of consciousness.
- Generalized seizures - These involve all areas of the brain and include several types such as absence seizures, tonic-clonic seizures, atonic seizures, and myoclonic seizures.
Diagnosis
Diagnosing epilepsy typically involves a combination of medical history review, neurological examinations, and tests such as electroencephalogram (EEG), magnetic resonance imaging (MRI), and blood tests.
Living with epilepsy
While epilepsy can present challenges, many people with the condition lead full, active lives. Proper management, including medication adherence, regular medical check-ups, and lifestyle adjustments, can help minimize the impact of epilepsy on daily life.
Continuous monitoring solutions like the Minder system can provide valuable insights for both patients and healthcare providers, potentially improving treatment outcomes and quality of life.
Treatment pathways
There are a variety of treatment pathways available for epilepsy, each tailored to address the specific needs of patients. Some of the following examples highlight these diverse approaches.
Antiseizure medications (ASMs)
- Broad-spectrum drugs: Treat various seizure types
- Narrow spectrum medications: Focus on focal/partial seizures
- Can be used alone (monotherapy) or combined (polytherapy)
Surgery options
- Resective surgery: Removes seizure-causing area
- Disconnection surgery: Cuts nerve pathways
Neuromodulation
- Vagus nerve stimulators: Neck/chest implants
- Responsive neurostimulators: Brain/skull implants
- Deep brain stimulators: Brain/chest implants
Dietary therapy
- A ketogenic diet may help control seizures in some individuals.
- High fat, low carbohydrate approach
Key studies
Discover essential research that informs epilepsy diagnosis and monitoring practices for better patient outcomes.
Drug resistant epilepsy and the journey
A journey into the unknown: An ethnographic examination of drug-resistant epilepsy treatment and management in the United States
Epilepsy & Behavior, 2021
Treatment Outcomes in Patients with Newly Diagnosed Epilepsy Treated With Established and New Antiepileptic Drugs: A 30-Year Longitudinal Cohort Study
JAMA Neurology, 2017
Early Identification of Refractory Epilepsy
The New England Journal of Medicine, 2000
Most seizures go under reported
Epilepsy: accuracy of patient seizure counts.
Archives of neurology, 2007
Over‐ and underreporting of seizures: How big is the problem?
Epilepsia, 2024
Unseen yet overcounted: The paradox of seizure frequency reporting
Epilepsy & Behavior, 2025
Seizure forecasting
Patient and caregiver perspectives on seizure prediction.
Epilepsy & behavior : E&B, 2010
Prediction of seizure likelihood with a long-term, implanted seizure advisory system in patients with drug-resistant epilepsy: a first-in-man study
The Lancet Neurology, 2013
Seizure Forecasting Using a Novel Sub-Scalp Ultra-Long Term EEG Monitoring System
Frontiers in Neurology, 2021