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Seizure Dogs Don’t Respond to Epilepsy?

There have been scattered reports of dogs that are able to predict their owners’ epileptic seizures well before they happen. Whether this forecasting skill is a product of a dog’s sixth sense, a unique ability found in only a few dogs or just a mere coincidence has never been confirmed.

But two new studies, published in Neurology, report that these service dogs may not be responding to an epileptic seizure at all, but instead to a psychological condition.

Service dogs can help to protect people in the case of a seizure. If they sense an oncoming episode, they are trained to alert their owner and make sure he or she sits in a safe place until the seizure is over. Additionally, these dogs may be trained to stay by their side to prevent injury in the case of a fall, alert others for help and stay with their owner until help arrives.

“They’re trained to be responder dogs,” said Dr. Brien Smith, a neurologist from the Henry Ford Hospital in Detroit, Michigan. “Some [of these dogs] will eventually be able to sense something is going wrong.”

But that part of the patient that is “going wrong” may not be an epileptic seizure after all.

In an epileptic seizure, neurons in the brain fire abnormally, causing the person to shake, convulse and black out. Psychogenic nonepileptic seizures (PNES), on the other hand, are not caused by a neurological problem. Instead, patients with this disorder have severe psychological distress that manifests itself as a seizure.

The cause of PNES is not fully understood. But it is estimated that up to 25 percent of patients with epilepsy have been diagnosed incorrectly and, in fact, have PNES.

To determine what type of seizure response dogs are truly sensing, researchers from Johns Hopkins University School of Medicine looked at seven people with seizure response dogs. Since only an epileptic seizure would cause a change in electrical activity in the brain, the researchers used electroencephalograms (EEG) to monitor for this unusual occurrence.

Ultimately, five of the study participants were diagnosed with PNES, not epilepsy.

“This is important because the treatment is very different for a person with epilepsy and one with psychological seizures, which stem from emotional difficulties,” said Dr. Gregory Krauss, study author.

Moreover, if people with psychological seizures use drugs for epilepsy, they may be putting themselves at risk.

“Epilepsy drugs are not effective for psychological seizures, and they often have side effects,” said Krauss. “With proper treatment and counseling, psychological seizures can often be eliminated.”

Krauss notes that some people with epilepsy may still benefit from service dogs, and adds that companion or service dogs may be helpful as emotional support for people with PNES, but they should not take the place of treatment.

“Seizure response dogs can help people during seizures and stay by them when they are unconscious and provide companionship that aids them in dealing with a chronic disorder,” said Krauss. “People with nonepileptic seizures require a psychiatric evaluation and therapy.”

“This study demonstrates the importance of establishing an accurate diagnosis of epilepsy before obtaining a seizure response dog,” he adds.