Daniel Goldenholz, MD, PhD, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, discusses the challenges with the current assumptions in epilepsy clinical trials. These assumptions presume that a participant’s seizure frequency is static, whereas in reality, a participant’s seizure frequency is variable. Through the use of seizure diaries, this has been illustrated. Therefore, clinical trials need to adapt to limit mistakes and the possibility of misclassifying treatments. This interview took place during the Virtual World Congress on Controversies in Neurology (CONy) 2020.