Responsive neurostimulation (RNS) uses an implanted device to prevent or stop oncoming seizures. This type of therapy may be recommended if you have seizures that do not respond to seizure medications.
RNS uses a neurostimulation device that is placed inside the skull. Neurostimulation devices are programmable, battery-powered devices that are surgically implanted to monitor brain waves and detect unusual electrical activity. If the device detects activity that can lead to a seizure, it will respond with pulses of nerve stimulation to help the brain waves return to normal. This response can stop a seizure before it begins or prevent seizure activity from spreading.
Before Responsive Neurostimulation
Your physician will ensure you are an ideal candidate for RNS before recommending the procedure. You may qualify for RNS if you:
- Are 18 years of age or older and have frequent, disabling seizures
- Have drug-resistant epilepsy, which means you have tried a minimum of two seizure medications to control seizures with no success
- Are unable to have epilepsy surgery. This may have been confirmed with diagnostic testing at a comprehensive epilepsy center.
- Have had resective epilepsy surgery with no success
During Responsive Neurostimulation
Implant surgery typically takes between two to five hours. During surgery, you will be under general anesthesia and feel no pain. The surgeon will make a small incision on the side or the back of the head and place the neurostimulator, the device that will deliver electrical stimulation. The device is attached to leads (wires) which connect to areas of the brain where seizures begin. The surgeon will make at least one more small incision to place the leads. Usually two leads are placed, but your surgeon may implant up to four. Only two leads will be connected to the device. The other two leads can be connected with a less invasive surgery at a later time, if needed.
You may need to stay in the hospital for a few days after surgery. This is to make sure you have no complications from the procedure and are safe to return home.
After Responsive Neurostimulation
After surgery, you will have regular follow-up visits with your physician to make sure your incisions are healing properly. Your physician will ensure your device stays secure and works properly. You’ll learn to use the remote monitor to collect data from your device and send it to your doctor. This information allows your healthcare provider to know if the neurostimulator’s settings should be adjusted. The remote monitor can also be used to temporarily stop stimulation. Your physician will give you instructions for how to record brain activity or stop stimulation.
RNS treatment will not make seizures completely disappear. It is designed to reduce seizures alongside your anti-seizure medication. However, you may begin to see seizures significantly decrease after two years of RNS. Many people experience an improved quality of life with time.