Counting seizures is not simple. Patients may not be aware of their seizures. Adherence to diary entry often is poor. Shake detectors pick up only seizures with rhythmic movements and suffer from false-positive results. Measurement of electrodermal response is a promising technology but sensitivity and specificity for partial seizures are uncertain. Video-electroencephalogram monitoring is accurate but of short duration and performed in an artificial and expensive environment. Invasive electroencephalogram electrodes can detect seizure-like patterns, sometimes of unknown clinical significance. Practical long-term electroencephalogram monitors are under development. Methods to rank seizure severity are subjective. New approaches and solutions are needed.