Responsive Neurostimulation (RNS® System)
Fellowship-trained functional neurosurgeons • Advanced neuromodulation for drug-resistant epilepsyRNS® System (NeuroPace®) is an FDA-approved responsive neurostimulation device for adults with drug-resistant focal epilepsy whose seizures continue despite medication. Unlike therapies that provide continuous stimulation, the RNS System continuously monitors your brain activity, detects abnormal electrical patterns that can lead to seizures, and delivers brief electrical stimulation designed to interrupt that activity before a seizure fully develops. The system also records brain activity over time, allowing your epilepsy team to personalize treatment based on your unique seizure patterns. Responsive neurostimulation is used alongside anti-seizure medications and can significantly reduce seizure frequency while preserving healthy brain tissue.
Key takeaways
- FDA-approved treatment for adults with drug-resistant focal epilepsy
- Designed for patients whose seizures continue despite medication
- Detects and responds to seizure activity in real time
- Delivers stimulation only when needed
- Preserves healthy brain tissue
- Records brain activity to help personalize treatment
- Most patients return home the day after surgery
| Treatment | Responsive Neurostimulation (RNS® System) |
| Manufacturer | NeuroPace® |
| Purpose | Reduce seizure frequency in adults with drug-resistant focal epilepsy |
| Candidates | Adults with one or two seizure foci whose seizures continue despite medication |
| Procedure | Implantation of a skull-mounted neurostimulator connected to one or more brain electrodes |
| Hospital Stay | Usually overnight |
| Anesthesia | General anesthesia |
| Recovery | Most patients return home the following day |
| Long-Term Care | Regular follow-up visits for device programming and review of recorded brain activity |
| Medication | Anti-seizure medications are typically continued following implantation |
The RNS System is considered an adjunctive therapy, meaning it works alongside anti-seizure medications rather than replacing them. Device settings are individualized and adjusted over time based on your brain activity and seizure patterns.
Am I a Candidate for the RNS® System?
Many people with epilepsy achieve good seizure control with anti-seizure medication. However, if seizures continue despite trying appropriate medications, additional treatment options may be available.
You may be a candidate for the RNS® System if you:
- Are 18 years of age or older
- Have focal (partial-onset) epilepsy
- Continue to have disabling seizures despite trying two or more anti-seizure medications
- Have seizures arising from one or two identifiable areas of the brain
- Are not an ideal candidate for traditional epilepsy surgery because seizures cannot be safely removed or originate from critical areas of the brain
Not everyone with medication-resistant epilepsy is a candidate for responsive neurostimulation. Some patients may benefit more from epilepsy surgery, laser interstitial thermal therapy (LITT), vagus nerve stimulation (VNS), or deep brain stimulation (DBS). If you meet these general criteria, the next step is a comprehensive epilepsy evaluation to determine whether the RNS® System is the most appropriate treatment for you.
How We Determine if the RNS® System Is Right for You
Before recommending the RNS® System, our epilepsy specialists perform a comprehensive evaluation to understand where your seizures originate and whether responsive neurostimulation is the most appropriate treatment.
Your evaluation may include:
- High-resolution MRI
- Electroencephalography (EEG)
- Video EEG monitoring
- CT scan
- Neuropsychological testing
- Intracranial monitoring
- Stereoelectroencephalography (SEEG)
These tests help identify the seizure focus, determine whether seizures originate from one or two areas, and guide personalized treatment recommendations.
See If You May Be a Candidate
Answer a few quick questions to see whether the RNS® System may be an option for your epilepsy. Based on your responses, we’ll let you know whether an evaluation with one of our epilepsy specialists may be appropriate.
Benefits and risks
Potential benefits
- Reduce seizure frequency
- Reduce seizure severity
- Preserve healthy brain tissue
- Provide personalized treatment based on your brain activity
- Record long-term brain activity that helps optimize treatment
- Improve quality of life
- Maintain cognitive function while reducing seizures
Possible risks
- Infection
- Bleeding
- Cerebrospinal fluid leak
- Temporary discomfort around the implant
- Device-related complications
- Future battery replacement surgery
- Continued seizures despite treatment
Long-term studies have demonstrated sustained seizure reduction for many patients treated with the RNS System. Your neurosurgeon will discuss the risks and benefits specific to your condition during your consultation.
What recovery looks like
- Day of Surgery The RNS System is implanted under general anesthesia. Most patients spend one night in the hospital for monitoring before returning home.
- First 1–2 Weeks Mild headache, swelling, or tenderness around the incision is common. Most patients gradually resume light daily activities while the incision heals. Your surgeon will provide instructions regarding bathing, lifting, driving, and returning to work.
- 2–6 Weeks As healing progresses, activity restrictions are gradually lifted. Most patients return to many of their normal routines, although recovery timelines vary depending on individual health and occupation.
- First Programming Visit After surgery, the RNS System is activated and programmed during an outpatient visit. Your physician adjusts the device settings based on your seizure history and ongoing brain activity.
- Ongoing Follow-Up Unlike many implanted devices, the RNS System is continually optimized over time. During follow-up visits, your epilepsy team reviews the brain activity recorded by the device and fine-tunes stimulation settings to maximize seizure control.
- Long-Term Recovery Seizure reduction often occurs gradually over several months as programming is refined. Most patients continue taking anti-seizure medications while treatment is optimized.
Frequently asked questions
What does RNS stand for?
RNS stands for responsive neurostimulation, a treatment that detects abnormal brain activity associated with seizures and delivers electrical stimulation only when needed.
What is the NeuroPace RNS System?
The NeuroPace RNS System is the FDA-approved responsive neurostimulation device used to treat adults with drug-resistant focal epilepsy.
Will the RNS System cure my epilepsy?
No. The goal is to reduce seizure frequency and improve seizure control. Some patients experience long seizure-free periods, while others experience fewer or less severe seizures.
Will I feel the stimulation?
Most patients do not feel the stimulation delivered by the device.
Will I still need anti-seizure medication?
Yes. Most patients continue taking anti-seizure medications after implantation. Medication adjustments may be made over time depending on seizure control.
How long does the battery last?
Battery life varies depending on your individual treatment settings. Your physician monitors battery status during follow-up visits and recommends replacement when appropriate.
Can I have an MRI?
MRI compatibility depends on your specific device and the type of MRI being performed. Your care team will provide guidance regarding MRI safety.
Can I travel with the RNS System?
Most patients return to normal daily activities, including travel. Your physician will provide information regarding airport security, identification cards, and other travel considerations.
This page is for general education and does not replace medical advice. Treatment decisions should be made with a qualified neurosurgeon based on your individual diagnosis and imaging. To discuss your options, call Atlantic Brain and Spine at 973.993.7100 or request a consultation.
Neuromodulation Specialists at Atlantic Brain and Spine
Your procedure is performed by fellowship-trained, board-certified neurosurgeons with expertise in epilepsy surgery and neuromodulation.
