What is epilepsy?
Epilepsy is a neurological condition where a person experiences recurrent seizures caused by abnormal electrical activity in the brain. A seizure is a transient episode of excessive, synchronous neuronal activity in the brain that is disruptive to normal function which leads to a range of symptoms.
While most seizures resolve spontaneously, prolonged seizures or recurrent episodes, such as status epilepticus, can be life‑threatening if untreated. Epilepsy is a complex condition with multiple potential causes, including genetic predisposition, structural brain abnormalities, infections, traumatic brain injuries and metabolic disorders. The exact cause of the disease is unknown in approximately 50% of cases.
Diagnosing epilepsy accurately is challenging
Epilepsy is difficult to diagnose due to a range of factors, including:
- Transient nature of seizures—Seizures are unpredictable and often occur outside of controlled medical settings, making direct observation by healthcare professionals rare.
- The occurrence of non‑epileptic seizures—All people with epilepsy experience seizures, but not all individuals with seizures have epilepsy. Correct diagnosis can be difficult, even for experienced healthcare professionals. Seizure mimics, including non‑epileptic seizures, are episodes that resemble epileptic seizures, but have other medical causes such as cardiovascular disease or psychological conditions
- The limitations of current diagnostic tools—While they can be effective in certain circumstances, current diagnostic tools have significant limitations, for example the low accuracy of self‑reported patient seizure diaries or the limited measurement duration of current EEG modalities.
What impact does Epilepsy have on patients?
Epilepsy can pose significant safety risks to patients due to loss of awareness, impaired motor control, increasing likelihood of accidental injury due to motor vehicle accidents, fractures, burns or drowning.
In addition to the direct health impact, epilepsy can have significant psychological and social effects on the quality of life for patients, including depression, anxiety and learning difficulties, and creating challenges in employment or other elements of life.
Mortality risk for patients with epilepsy is two to three times higher compared to the general population.
Global impact
- Affects over 52 million people worldwide
- Fourth most common neurological disorder
- In the US:
- 3.4 million people affected (3.0 million adults, 0.4 million children)
- 150,000 new diagnoses annually
Drug-resistant epilepsy
- Affects ~1.1m adult epilepsy patients in the US
- Defined as failure to achieve seizure freedom after two adequate anti-seizure medication (ASM) trials
- Requires specialised treatment approaches
Understanding epilepsy
Epilepsy affects over 52 million people worldwide and is the fourth most common neurological disorder after migraines, strokes and Alzheimer's disease.
Epilepsy is a neurological condition where a person experiences recurrent seizures caused by abnormal electrical activity in the brain. A seizure is a transient episode of excessive, synchronous neuronal activity in the brain that disrupts normal function, leading to a range of symptoms.
Seizures can present with a variety of clinical manifestations; some involve motor symptoms, such as intense muscle contractions, while others, such as absence or focal impaired awareness seizures, may present with subtle or no outward physical signs. The occurrence of seizures varies in frequency among patients, from less than one a year to several a day.
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 have the potential to provide valuable insights for both patients and healthcare providers, opening the possibility of improved 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 a wide variety of seizure types and are often the initial treatment path
- 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
Key studies
Discover essential research that informs epilepsy diagnosis and monitoring practices for better patient outcomes.
Drug resistant epilepsy and the patient journey
The UMPIRE study: A first‐in‐human multicenter trial of bilateral subscalp monitoring for epileptic seizure detection
Epilepsia, 2025
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
Unseen yet overcounted: The paradox of seizure frequency reporting
Epilepsy & Behavior, 2025
Over‐ and underreporting of seizures: How big is the problem?
Epilepsia, 2024
Epilepsy: accuracy of patient seizure counts.
Archives of neurology, 2007
Seizure forecasting
Seizure Forecasting Using a Novel Sub-Scalp Ultra-Long Term EEG Monitoring System
Frontiers in Neurology, 2021
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
Patient and caregiver perspectives on seizure prediction.
Epilepsy & behavior : E&B, 2010