Electroencephalography (EEG) is the gold standard for seizure detection. However, EEG systems are usually expensive and require well-trained technicians for data acquisition. Detection of seizures is important in patients with refractory epilepsy, especially when the seizure is prolonged and unwitnessed. Sudden unexpected death in epilepsy (SUDEP) is an important problem in patients with refractory epilepsy because the risk of SUDEP decreases the quality of life. There are several alternatives to EEG systems that are used to detect seizure-related pathophysiological changes. Measurements of heart rate and heart rate variability can be used to detect seizure-related cardiologic phenomena. Respiratory signals obtained based on respiration rate and respiratory chest and abdominal movements may also be used for seizure detection. Ictal movements can be detected using video analysis or wearable devices, such as accelerometers and gyroscopes. In addition, electrodermal activity (EDA) measurements are currently under investigation as a way to alert others to an ictal period. Although these technologies have limitations, they are affordable and easily wearable. They are thus appropriate for use in patients during daily activity. These devices may be potentially useful to detect the occurrence of unwitnessed seizures, and to increase the quality of life.