Table 1.

Inclusion criteria.

Inclusion criteria

Exclusion criteria

• Aged 18 years or older; • Confirmed diagnosis of epilepsy by a neurologist with video or electroencephalographic (EEG) confirmation; • Failure of adequate trials of two tolerated, appropriately chosen and used AED regimen to achieve sustained seizure freedom (i.e., medically refractory epilepsy); • Not eligible for resective surgery, not prepared to accept the risks of resective surgery, or resective surgery has not resulted in seizure freedom; • Prepared not to commence with a ketogenic diet during the study period; • Minimum of 2 seizures per week on average over the last 6 monthsa; • High risk of injury or dysfunction due to seizures associated with reduced awareness and/or a loss of balance; • Seizures are not preceded by a warning signal that allows the PWE to act on the impending seizure; • Capacity to take care of the dog and back-up support in the environment of the PWE to temporarily take over the care of the dog if necessary; • Adequacy to fill in questionnaires and seizure diaries, either alone or with the support of a caregiver.

• Predominance of psychogenic non-epileptic seizures; • Institutionalized in a 24/7 care home; • Currently in possession of a trained (either active or retired) seizure dog; • A planned epilepsy surgery, deep brain simulation surgery, or vagus nerve stimulation surgery within the trial duration; • Disabilities that would require additional, non-seizure related assistance dog tasks (e.g., dependence on a wheelchair).

^aAll types of epileptic seizures may be included in the seizure count. However, given the further criteria (e.g., high risk of injury and/or dysfunction), PWE with tonic-clonic seizures, tonic seizures, clonic seizures, atonic seizures, and/or some focal dyscognitive seizures are most likely to be included in the study.