Navigating The Maze: Seizure Management And Epilepsy Clinical Trials

By Pascal Goetghebeur, Lewis M. Fredane, MD, & Manuela Bossi, PhD

Epilepsy affects over 50 million people globally, yet clinical trials aimed at improving seizure management face persistent obstacles. The unpredictability and variability of seizures challenge consistent data collection, while outdated self-reporting tools like paper diaries often yield unreliable results. High placebo response rates further complicate trial accuracy, especially in pediatric and treatment-resistant cases. Cognitive and psychiatric comorbidities, common in people with epilepsy, add layers of complexity to both data interpretation and patient experience. Recruitment and retention are also hindered by stigma, rare seizure subtypes, and the burdens of participation. Moreover, ethical and regulatory demands—particularly for vulnerable populations like children—make trial design more intricate.

To address these issues, innovations such as electronic diaries (eDiaries), wearable seizure monitoring, and standardized cognitive assessments have emerged. These tools enhance data reliability, support participant engagement, and enable comprehensive tracking of seizure activity and cognitive function. By prioritizing patient-centered measures and modern technology, the landscape of epilepsy research is shifting toward more accurate, ethical, and inclusive clinical trials, ultimately advancing treatment development and quality of life for those living with epilepsy.