Epileptic seizure alarms
Topic Status Complete
Wearable and bed-based technologies to detect tonic-clonic seizures in people with epilepsy
Specialities: Nervous system
Outcome of the appraisal
More evidence is needed on wearable and bed-based technologies for detecting tonic-clonic seizures in people with epilepsy.
There was limited clinical effectiveness evidence for wearable and bed-based technologies to detect tonic-clonic seizures in people with epilepsy.
HTW was unable to determine cost effectiveness from a Welsh perspective due to an insufficient evidence base to develop an economic model.
Why was this topic appraised?
Tonic-clonic seizures pose major risks, including serious injury, and are the strongest predictor of sudden unexpected death in epilepsy (SUDEP). Out of hospital, most people rely on informal monitoring of seizure activity, such as caregiver supervision or baby monitors, which are often unreliable. The need for improved real-time detection in the home, particularly in unattended people during nighttime hours, was highlighted by an NHS Wales consultant neurologist who proposed this topic for review.
Plain language summary
What is Epilepsy?
Epilepsy is condition that affects the brain. People with epilepsy typically experience seizures. Depending on the type, a seizure can include:
- The body becoming stiff or floppy
- suddenly falling to the floor
- jerking or twitching movements
- peeing unintentionally
- losing awareness – staring into space and not be able to respond normally
- unusual feelings or sensations, such as strange smells, numbness or tingling, changes in vision, or suddenly feeling scared
- unusual behavior, such as fidgeting or walking around and not being aware
A tonic-clonic seizure may affect both sides of the brain from the start, or can start in one side of the brain and spread to the other.
A seizure can be dangerous, as there is a risk it can lead to injury or a fatality, especially when occurring during sleep. People with epilepsy need their seizures monitored to reduce this risk and keep them safe. However, monitoring can be difficult, especially overnight, for people who live or sleep alone. Seizure monitoring is also used to help guide treatment.
How is epilepsy monitored?
People with epilepsy mostly rely on the help of others to monitor their seizures. Some people may use things like baby monitors to help alert them to the sounds or movements of a seizure.
What are Epilepsy alarms?
Epilepsy alarms aim to detect when someone is having a seizure. Alarms can be things like specific epilepsy watches or armbands, or bed and/or mattress alarms. The monitors use things such as brain activity, movement and/or heart-rate sensors to detect the abnormal activity associated with seizures. Once a seizure is detected, the monitor triggers an alert through sound, vibration or notification to caregivers or family members. Currently, there are no specified technologies recommended by the NHS to provide to people.
What did Health Technology Wales do?
HTW looked for evidence on the use of epilepsy alarms. More evidence is needed on wearable and bed-based technologies for detecting tonic-clonic seizures in people with epilepsy.
Guidance
GUI076 05.2026
Evidence Appraisal Report
EAR076 05.2026
Topic Exploration Report
TER609 07.2025 (superseded by EAR076 05.2026)
Health Technology Wales Partners
