Gregory L. Krauss, MD, and colleagues examined three patients who claimed that their dogs could detect seizure onset. Two of these patients underwent video-EEG monitoring. In one patient, EEG results showed that the patient’s dog abruptly licked the patient’s face 30 seconds prior to a seizure that lasted two minutes. Dr. Krauss and colleagues also performed EEG on a fourth patient, who claimed that her dog barked repeatedly to alert the patient’s husband that she was about to have a confusional episode. However, the three patients who underwent EEG did not have EEG abnormalities. All four patients were subsequently found to have psychogenic nonepileptic seizures.
“These cases show that patients with abnormal illness behaviors may seek service animals for support and demonstrate the importance of establishing an accurate diagnosis of epilepsy before patients obtain epileptic seizure response dogs,” Dr. Krauss and colleagues stated. “Service animals should match the patients’ condition and should be provided by skilled professional organizations.”
In a separate study, Michael J. Doherty, MD, and Alan M. Haltiner, PhD, examined a couple who reported that their dog could both alert them to and respond to seizure activity. The couple claimed that the dog would lie on the wife’s chest before and during a convulsive episode and would also get help from neighbors after a seizure incident. Her episodes were recorded by video-EEG telemetry and diagnosed as psychogenic nonepileptic seizures.
Drs. Doherty and Haltiner noted that their findings allow for several possibilities as to how the ability of seizure response dogs to predict and respond to seizures should be evaluated. The researchers speculated that psychogenic nonepileptic seizures could be viewed as unconditioned responses to stereotyped dog behaviors, or that the dogs are able to detect early ictus, which patients or their family members assume to be evidence of preseizure.
“Both studies suggest a potential therapeutic effect in owning such dogs, but that the benefit is more likely to be psychological than neurologic,” stated Brian Litt, MD, and Abba Kreiger, PhD, in an accompanying editorial. “In both studies it was only objective validation of patient-reported events that led to the appropriate diagnosis and conclusions.”