Last reviewed October 2026. This guide is general information, not medical or care advice.
Wearing and maintaining a necklace alarm
A necklace alarm only helps when it is worn. Comfort, the lanyard or clasp, charging, and the daily routine matter more than a long feature list. Try the format before committing to a monitoring term.
A necklace may need to sit in a particular position for a seizure sensor to work. Ask the supplier and clinician how the device should be worn.
Check the necklace for wear, confirm the battery routine, and make sure the wearer can put it on without help. If the wearer finds the necklace uncomfortable, test a necklace or wrist option before giving up on the response plan.
- Confirm the necklace is comfortable enough for all-day wear.
- Check whether it can be worn in the shower or bath.
- Ask how the battery is charged and what warning is given.
- Test the breakaway or clasp with the wearer.
- Make sure the necklace does not interfere with hearing aids or clothing.
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.
A necklace format only helps when it stays around the neck. Before comparing technical features, check whether the necklace is light enough, the cord is comfortable, and the clasp can be managed by the person wearing it. A device that needs help to put on is less likely to be worn daily.
- 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.
The clasp deserves particular attention. Look for a fastening the wearer can use without looking in a mirror, and check whether the cord can be adjusted or replaced. If the wearer has limited hand strength, a different format may be more practical.
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.
Someone who removes jewellery for sleep, bathing, or dressing needs a clear routine for putting the alarm back on. Pair it with an existing habit, such as getting dressed or making breakfast, so the necklace does not stay on the bedside table.
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 necklace alarm can be discreet, but discretion should not come at the cost of the button. Check that the wearer can find and press the alert without fumbling, and that the necklace does not swing away from the body when they move.
- 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
Can a seizure alarm predict a seizure?
No. Most seizure alarms detect movement during or after a seizure. They are not reliable predictors. Any prediction claim should be treated with caution and discussed with the epilepsy team.
Will a seizure alarm detect every seizure?
No. Detection depends on the seizure type, the device, and how it is worn. Seizures without prominent movement may not be detected. Ask the provider about the limitations for the specific seizure pattern.
Does the NHS provide seizure alarms?
Availability varies by local service and individual assessment. Ask the epilepsy team or local authority what equipment and support may be available. A private device may be an alternative, but it should fit the care plan.
What should I do if the alarm goes off?
Follow the agreed response plan. Check on the person, provide first aid if needed, and call 999 if the seizure is prolonged, repeated, or the person is injured or not breathing normally. Do not restrain the person.
Sources and further reading
These sources were used to check the general guidance in this guide. They do not imply endorsement of any product.