Responsive neurostimulation (RNS) is an advanced epilepsy treatment that offers new hope for some children with drug-resistant epilepsy (seizures that don’t respond to medication). 

At the Washington University Pediatric Epilepsy Center at St. Louis Children’s Hospital, our team has safely offered this novel treatment to children since the device’s FDA approval in 2013. RNS involves implanting a device inside the skull to stop seizures where and when they start.

What Is Responsive Neurostimulation?

The NeuroPace RNS® system is a sophisticated network of electrodes connected to a device that is implanted inside the skull. The device is similar to a pacemaker. It continuously monitors and records your child’s brainwaves. Doctors use that information to customize, or train, the device to detect and prevent potential seizures and stop them or lessen their severity. 

When the device detects a change from the brain’s normal brainwave pattern, it emits short pulses of electrical stimulation. These pulses help to normalize brainwave signals, stop seizures from spreading, and can prevent future seizures. For some children, this device has shown to reduce seizure severity or stop seizures entirely. 

Is epilepsy surgery right for your child? Learn more about epilepsy treatment options and our comprehensive epilepsy surgery evaluation.

When Is Responsive Neurostimulation Offered?

When medication isn’t enough to manage a child’s seizures, your doctor may consider alternative therapies, such as dietary therapies, surgery and neurostimulation. Children whose seizures can be traced back to one or two areas of the brain may benefit from responsive neurostimulation.

NeuroPace Implantation: What to Expect

During a NeuroPace implantation procedure, a neurosurgeon:

  1. Carefully places leads (electrodes attached to tiny wires) on or inside a child’s brain, near where seizures start
  2. Places the neurostimulation device (similar to a cardiac pacemaker) in the skull bone, right under the scalp
  3. Connects wires from the electrodes to the device, allowing the device to record continuous brainwave data

After the procedure, doctors closely monitor the device as electrodes record seizures. This information allows doctors to train the device to detect seizures. Once doctors have the information they need, they program the device to stimulate the part of the brain near where seizures start, precisely when the device detects a potential seizure. 

Because neurostimulation systems are highly customized, our doctors closely monitor children in the weeks and months after implanting the device. They may make adjustments to the programming over time, to increase its effectiveness. For this reason, most children do not experience full treatment benefits right away.

A Family-Centered Approach to Epilepsy Surgery

No parent considers brain surgery for their child lightly. Our team guides families through the surgical evaluation process, with expertise and compassion. At our Pediatric Epilepsy Advanced Technologies Clinic, doctors conduct a thorough evaluation of your child’s health.

We also talk through families’ questions, concerns and treatment options. A nurse coordinator helps schedule any additional diagnostic tests your child may need and explains what you can expect during the care process.

Learn more about the careful consideration we take when evaluating a child for surgery in our helpful guide to the patient journey.