Seizure alarms: what they detect and who they help for pendant users

Pendant fit, wear, and response

A pendant alarm is a familiar format, but fit and routine decide whether it is worn. Check the cord or clip, the weight, the charging method, and whether the wearer can use it without help.

Seizure detection is not the same as fall detection. Confirm with the supplier and clinician whether the pendant is suitable for the type of seizure involved.

Test the pendant in the rooms and outdoor spaces the wearer uses. Confirm the response plan with the monitoring centre or nominated contacts, and review the choice if the wearer's mobility or memory changes.

• Try the pendant with the clothes the wearer normally uses.
• Check the cord, clip, or breakaway fitting for comfort and safety.
• Confirm the charging routine and low-battery warning.
• Ask whether the pendant is waterproof.
• Test the button and the response from outside the home.

How seizure alarms differ from general alarms

A general personal alarm waits for the wearer to press a button. A seizure alarm tries to detect a pattern of movement, such as repetitive jerking or a change in position in bed, and raises an alert without a button press. Some systems combine a wearable sensor with a bed sensor.

This can help when a person cannot press a button during a seizure, but the technology is not a diagnosis. It identifies a movement pattern that may be associated with a seizure. The response still depends on the monitoring centre, family contacts, and the care plan.

Pendant position matters for comfort and for the button. Check where the device sits against the chest, whether the cord length can be adjusted, and whether the wearer can reach the alert without pulling at the cord.

• Wearable sensors may detect repetitive movement or a sudden change in posture.
• Bed sensors may detect unusual movement or a person leaving the bed.
• Some systems use both a wearable and a bed sensor.
• The alert must reach someone who knows what to do.

What the alarm can and cannot detect

Seizure alarms are designed for specific seizure patterns, often tonic-clonic seizures or nighttime convulsions. They are less reliable for seizures without prominent movement, such as some focal seizures, absence seizures, or seizures where the person remains still. A device may also miss a seizure if it is not worn correctly or the battery is low.

False alerts can occur with other repetitive movements, such as scratching, tooth brushing, or bed partner movement. Ask the provider how the device is tuned and whether the sensitivity can be adjusted. A high false-alert rate can lead to alert fatigue, which is a safety risk in itself.

If a lanyard feels awkward, compare a wrist alarm or a belt clip before giving up on the idea. The best format is the one the person will keep on, even if it is not the one the family expected to choose.

Who may benefit

A seizure alarm may be considered when someone has seizures that could lead to injury, especially at night, and when they cannot reliably call for help during or after a seizure. It may also help families who need to know when a seizure has occurred so they can provide support.

It is less useful if seizures are well controlled, if the person can summon help, or if the response would not change. The decision should involve the person, their family or carers, and the epilepsy team. Ask whether the alarm fits the seizure type and the care plan.

Button access should be tested with the person who will use it. Ask them to press it while standing, sitting, and lying down. If the button is hard to find or requires two hands, the device is not a good fit.

Build a response plan

Write down what should happen when an alert is received. Who will check on the person? When should an ambulance be called? What information should be given to emergency services? The plan should reflect the person's seizure history and the advice of their clinician.

Include practical details such as the address, access instructions, known triggers, medication, and emergency contacts. If the person lives alone, agree who will hold a key and how a welfare check will be carried out. Review the plan after every seizure that triggers an alert.

A pendant routine works best when it is tied to something that already happens every day. Charging while reading, watching television, or getting ready in the morning is easier to remember than an arbitrary reminder.

• Who receives the alert first, and who is the backup?
• When should the responder call 999?
• What seizure information should be shared with the ambulance service?
• How will the person be checked on if they do not respond?
• When will the plan be reviewed with the epilepsy team?

Questions to ask before buying

Ask which seizure patterns the device is designed to detect and how it performs for the person's seizure type. Confirm whether it works at night, in bed, and outside the home. Check the battery life, charging routine, and mobile or broadband coverage at the address.

Ask about the monitoring plan, the escalation process, and the cost of the device and any subscription. Confirm the returns policy and whether the device can be tested. If the provider cannot explain the limitations clearly, look for an alternative or ask the epilepsy team for advice.

• Which seizure types is the device intended to detect?
• Does it work in bed and during sleep?
• What is the false-alert rate and how is it handled?
• Is monitoring included, or does it call family contacts?
• What happens during a power cut or loss of connection?
• Can the device be trialled before committing to a contract?

Questions people ask

Sources and further reading

These sources were used to check the general guidance in this guide. They do not imply endorsement of any product.

• Epilepsy Action — Seizure alarms
• NHS — Epilepsy
• SUDEP Action — Safety
• Epilepsy Foundation — Seizure detection devices