Exploring Trends and Sentiments in Epilepsy Discussions: A Thematic Analysis of the r/Epilepsy Subreddit (2023-2024)

Background: In 2024, Reddit, an emerging social media platform, saw a 50% increase in monthly users to nearly 100 million. Reddit has also emerged as a significant space for discussions about health conditions, including epilepsy, which affects about 50 million people globally. Purpose: This study aims to explore trends in the volume, timing, themes, emotional tone, and sentiment of posts on the r/Epilepsy subreddit from 1 December 2023 to 31 December 2024. Methods: We collected 25,222 original English-language posts from r/Epilepsy using Reddit's Application Programming Interface (API). Data extraction was restricted to English-language submissions to ensure compatibility with sentiment and thematic analyses. We analyzed post volume and timing using chi-square tests and Poisson regression. Emotional tone was measured using TextBlob (version 0.19.0), while compound sentiment scores were calculated via VADER (Valence Aware Dictionary and Sentiment Reasoner) (NLTK version 3.9.1). A Pearson correlation assessed agreement between sentiment and emotional tone, with statistical significance set at p < 0.05. Thematic analysis was conducted using a KMeans clustering algorithm (scikit-learn version 1.6.1) to identify recurring discussion topics. Results: Total monthly posts steadily increased, with the highest number (2175) in December 2024. Peak posts in descending order were in December 2024, August 2024, and November 2024. Posts were not evenly distributed across the week, with a significant peak on Mondays (χ² = 86.75, p < 0.001) and Poisson regression confirming higher activity early in the week (p = 0.001). Emotional tones fluctuated, with positive sentiments in January and October 2024, and negative sentiments in March and August 2024. KMeans clustering identified five main themes: treatment experiences, community engagement, personal experiences, solidarity, and subreddit gratitude. Manual validation of a random subset of posts demonstrated moderate concordance between automated sentiment classification and human ratings. Conclusions: This study highlights temporal patterns, sentiment dynamics, and thematic structure in online discussions on epilepsy. Social media may offer valuable, real-time insights into patient-centered concerns and community engagement, which can inform healthcare professionals and advocacy groups in supporting individuals affected by epilepsy. Future studies may compare trends of epilepsy discussions across various social media platforms, such as X and Instagram, to further understand online patient experiences.