Is RNS an effective treatment for epilepsy?

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Is RNS an effective treatment for epilepsy?

Responsive neurostimulation (RNS) is a treatment option that may help to reduce the frequency of seizures. While it does not cure the condition, it is a generally safe, effective, and reversible option to help manage epilepsy.

Epilepsy is a common brain condition that can result in seizures. There are various different types of epilepsy that individuals can experience, as well as different types of seizures. As such, there are also various treatment options available, such as surgery, depending on an individual’s diagnosis and situation.

In this article, we will discuss whether RNS is an effective option for treating epilepsy.

What is responsive neurostimulation?

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RNS is a seizure treatment option that received approval from the Food and Drug Administration (FDA) in 2013. Some health experts may also refer to this device as the RNS System.

RNS uses an implanted device that helps to prevent seizures before they begin, similar to how a pacemaker detects and treats arrhythmias.

A medical professional may consider this treatment option to help reduce the frequency of seizures in individuals 18 years of age or older. In particular, they may help to treat partial onset seizures in individuals where:

  • the seizures originate in one or two areas of the brain
  • seizures continue after taking two or more anti-epileptic medications
  • seizures are frequent and disabling

How does RNS work?

RNS is a small battery-powered device, known as a neurostimulator, that a surgeon implants into a person’s skull, under the scalp.

The device features one or two wires that connect to the areas of the brain where the seizures originate. The device then monitors the brain’s electrical activity and detects activity that could lead to a seizure.

If the device notices abnormal brain activity, it will deliver a pulse of electrical stimulation through the leads to the brain. This electrical pulse can help to prevent or shorten the seizure.

The device is not visible and a person will not feel the stimulation or other unusual sensations. RNS for epilepsy is not permanent and a doctor can turn it off and remove the device if a person wishes to discontinue it.

Effectiveness and side effects of RNS

While RNS is not a cure for epilepsy, it can help to decrease the number of seizures a person may experience. A 2020 study notes that individuals using RNS saw a 67% decrease in seizures after 1 year, 75% after 2 years, and up to 82% after 3+ years of using RNS for epilepsy.

In the study, some people experienced extended periods of time with no seizures, with 1 out of 3 people reporting no seizures for 6 months in a row.

A 2015 study also adds that using RNS for epilepsy can improve the overall quality of life. These effects included improved physical health, ability to think, and emotional health or mood, as well as experiencing less worry about seizures.

Additionally, a 2020 study notes that RNS is a safe and effective option that can help to reduce the frequency of seizures and improve quality of life. However, the effects of RNS are not immediate and may require time to observe the benefits.

Who is RNS suitable for?

According to the Epilepsy Foundation, a person is a good candidate for RNS if they are an adult with drug-resistant epilepsy and have two or fewer seizure foci. This refers to areas in the brain where seizures start.

It may also be an option for those who are not able to have epilepsy surgery or have had resective surgery and are still experiencing seizures.

How long does RNS surgery and subsequent recovery take?

The surgical procedure to implant RNS for epilepsy typically takes 2–4 hours.

Individuals will receive general anesthesia during this procedure. Most people can return home the same day, though others may need to stay at the hospital for 1–3 days.

However, no bed rest is necessary following this procedure and most people can resume their usual activities within a few days and return to work within 2–4 weeks.

Summary

Responsive neurostimulation is a treatment option that may help to manage seizures a person experiences due to epilepsy. It involves an implantable device that monitors the electrical activity in the brain and sends pulses to prevent or shorten seizures.

While the device cannot cure epilepsy, it can help to reduce the frequency of seizures and help to improve quality of life. A person can discuss RNS with their doctor to determine if they are a suitable candidate for this treatment.

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