Selection and management for procedures:
DBS, RNS and VNS

After trying multiple medications, some patients will still continue to have uncontrolled seizures. Out of these Refractory Epilepsy patients, our team of neurologists can determine which of those would benefit from a neuromodulation device. Vagus nerve stimulation (VNS Therapy®), responsive neurostimulation (RNS® Therapy), and deep brain stimulation are three types of implanted devices for epilepsy management. These devices are implanted by a neurosurgeon and our neurologists can help coordinate with the patient and surgeon in order to determine which device may be the best choice for them. These devices are part of a long-term seizure management plan and can greatly reduce the severity of seizures in some patients. Most people with neuromodulation devices still need to take seizure medication.

Vagus Nerve Stimulation (VNS) is a seizure management tool that involves implanting a pacemaker-like device in the chest that generates pulses of electricity to stimulate the vagus nerve in the neck. The VNS also has a magnet which is an emergency tool that can be used by the patient or family that can send stronger impulses during a seizure to stop or shorten the seizure. The VNS is placed by a neurosurgeon, the settings are adjusted during outpatient visits with our neurologists.

Responsive Nerve Stimulation (RNS) is a neuromodulation device implanted by a neurosurgeon. A device is placed in the bone covering the brain. Tiny wires or leads are placed in one or two places on top of the brain where seizure activity may begin, these wires can monitor the patient’s seizure frequency and detect when a patient may be having seizure activity and respond by giving a small burst of stimulation to help brain activity return to normal.

Deep brain stimulation (DBS) is another neuromodulation device implanted in the brain by a neurosurgeon. The device is programmed by the neurologist deliver electrical currents. The stimulation is delivered in a preset cycle and not directly in response to a seizure. These electrical currents affect the excitability of certain circuits of the brain and help prevent seizures or reduce their frequency.