Responsive Neurostimulation

Overview

What it is
Responsive Neurostimulation (RNS) is a relatively new modality for the treatment of epilepsy, using brain stimulation rather than resection or ablation. It is responsive because the device (“Neuropace”) “listens” to the brain and when a seizure onset is detected, a pulse of stimulation is delivered to abort the seizure.

Who can benefit
RNS is particularly useful for patients who have seizures originating from well-defined regions of the brain, but where resection or ablation would cause intolerable side effects.

How it works
Neurosurgery is undertaken to implant electrodes over or into the area giving rise to seizures, and then these electrodes are connected to a small device that is lowered into a small recess drilled into the skull. This device records neural activity and is programmed to deliver stimulation when a seizure is detected. Patients upload data from the device wirelessly, and then transmit their data securely to neurologists who can review the neural recordings and set stimulation thresholds appropriately. Surgery to replace the battery is required every few years.