A new treatment for seizures? Let's learn about Responsive Neurostimulation (RNS)

Do you or someone you know have epilepsy that is difficult to control despite taking medication? We know how difficult it can be to live with such conditions at times. But with the advancement of medical science, new treatments have now emerged for this. Today, we are going to talk about one such new and successful treatment method. This is called Responsive Neurostimulation, or RNS for short.

Simply put, what is RNS?

Imagine that there is a small, very intelligent guard inside your brain. As soon as a seizure is about to occur, that is, when an abnormal electrical activity in the brain begins, this guard recognizes it and immediately sends a small electrical signal to stop that abnormal activity. That is what this device called RNS does.

Simply put, an RNS is a small device that is surgically implanted in your body. It continuously monitors the electrical activity in your brain where seizures are occurring. When it detects abnormal electrical activity, it responds very quickly and sends a series of small electrical pulses to that area. Over time, this electrical energy gradually reduces the ability of your brain to cause seizures.

Once the device is fitted, your doctor can adjust its settings to suit your needs. It can also be surgically removed if necessary.

Who is this RNS treatment suitable for?

This treatment method is not suitable for everyone. Usually, a doctor recommends it after considering certain factors.

• Seizures that are not controlled by medication: If you have difficulty controlling your seizures even though you are using antiseizure medications correctly.
• Focal Seizures: If your seizures start in one specific area of ​​the brain.
• If other surgeries are not suitable: If there are any risks involved in performing other surgeries or if a previous surgery has failed.
• For people over 18 years of age: This treatment is currently approved for people over 18 years of age.

How do you prepare before surgery?

Since this is a brain surgery, your doctor will do a lot of tests before the procedure. The main goal is to find out exactly where in your brain the seizures are starting. Because that's where the electrodes we mentioned need to be placed.

For this, you will have to do several tests one by one.

• Video-EEG Monitoring
• MRI scan
• A PET scan
• Magnetoencephalography (MEG)
• Ictal SPECT
• Neuropsychiatric testing
• Intracranial EEG monitoring (SEEG or subdural evaluation)

In addition to these tests, your doctor will also ask about your health history, allergies, and any medications you take. So, be sure to bring all of these details with you when you visit your doctor.

What happens on the day of the surgery?

On the day of the surgery, you will be fully anesthetized. So you won't feel any pain. You will be asleep.

Then, in the operating room, the surgeon follows these steps:

1. Hair removal: A small strip of hair is removed only at the surgical site. Don't worry about it, hair will grow back after the surgery.

2. Opening the skull: The skin is cut and a very small opening (craniectomy) is made in the skull.

3. Implantation of electrodes: Very thin wire-like electrodes are inserted into the part of the brain where the seizure is occurring. These measure the brain's electrical activity and deliver stimulation.

4e. Device placement: The RNS device (a small computer-like device) is placed inside the skull, just above the brain.

5. Checking and closing: The device is checked to make sure it is working properly, and the incision is sewn back shut.

This surgery can usually take about two to four hours.

What happens after the surgery?

After the surgery, you will need to stay in the hospital for two to three days. During this time, the device will start working, but it will only be "listening" to brain activity. That is, collecting data.

Electrical stimulation is started after two to four weeks, after the wound has fully healed. For that, you will need to see the doctor again. That's when he will "turn on" the device and begin the stimulation treatment.

Start at a very low level and gradually change the settings until you find the level that suits you best.

Data monitoring from home

You will receive a small computer-like device and a wand (a piece of equipment) attached to it to use at home. When you place the wand on your head, all the data from the device is downloaded to the computer. The data is then sent over the Internet to a secure website. Your doctor can look at that data and learn a lot about your condition, such as how often you have seizures and what time of day they occur most often. Using this information, he or she may even be able to adjust your medication dosage.

When to call the doctor

After surgery, if you have severe pain, bleeding, or swelling at the incision site, notify your doctor immediately.

After turning on the device and starting the stimulation, if you experience any discomfort, such as dizziness, changes in vision, or numbness, tell your doctor about it. Don't worry, since the stimulation level of this device can be adjusted, your doctor can adjust it to a level that is comfortable for you.

Let's also learn about the recovery time and battery.

Although it can take up to 8 weeks to fully recover, you can usually resume your daily activities (such as going to work or school) within 2-4 weeks. However, do not do any strenuous activities without consulting your doctor.

The battery in this device can usually be used for about 8-10 years . When the battery needs to be replaced, the entire device does not need to be replaced. It does not require a major surgery like the previous surgery. It is much simpler, and you can replace just the battery with a small surgery.

Seizures, Migraines, RNS, Responsive Neurostimulation, Brain Surgery, Epilepsy Treatment, Neurostimulation