Neurostimulator Treatment for Epilepsy

Our approach

The Northwell Health Neuroscience Institute ensures the best neurological care for you and your family, including thorough neurological evaluations, the latest diagnostic technology and the most advanced treatment options, including neurostimulator treatment for epilepsy.  

Neurostimulator treatment

Neurostimulator treatment is a type of surgery that uses small implantable battery powered “pacemaker-like” devices that are currently available to either stimulate the vagus nerve – cranial nerve originating in the brain that travels in the neck to the rest of the body, or to stimulate directly the brain regions triggering seizures.

The first of these devices, the ‘Vagal Nerve Stimulator’ (VNS) stimulates the vagus nerve at intervals of a few minutes to reduce the frequency and strength of seizure.  Individuals with the VNS device can also activate the VNS stimulation non-invasively by using a magnet that is provided at the time the device is placed.  The strength of stimulation is gradually adjusted by the doctors during regular office visits by using a non-invasive programming wand that communicates wirelessly with the stimulator. The VNS stimulator battery and pacemaker unit are implanted under the skin in the chest, and the stimulation lead is connected to the vagus nerve as it travels through the neck.

The second neurostimulation device available for epilepsy is the “Responsive Neurostimulation System” (RNS) from Neuropace.  This device works by continuously analyzing brain activity to detect a seizure and delivering stimulation whenever a seizure is detected.  By applying stimulation at the beginning of the seizure, the RNS device attempts to block the seizure from progressing to where it produces symptoms. The RNS battery and pacemaker unit are implanted in the bone of the skull and the stimulation leads travel from the unit to the brain region triggering seizures. 

Neurostimulator treatment for epilepsy risks

VNS and RNS neurostimulator treatment are both considered safe and effective with minimal risks and side effectsFor VNS, risks include:

  • Cough or horseness, usually eliminated by adjusting the stimulation intensity.

For RNS, which involves placing the stimulation leads in the brain, similar to the approach used for deep brain stimulation for Parkinson disease, the risks include:

  • Leakage of cerebrospinal fluid

For both devices, as with any surgery, there is also a risk of

  • Allergic reaction to the device
  • Infection
  • Temporary pain or swelling at the implantation site
  • Temporary tingling of the face, arms or legs

In a small percentage of individuals, the VNS or RNS stimulation lead or battery device can break or shift. In these cases, the device will need to be removed and replaced.

 

What to expect after treatment

After neurostimulator treatment, you will stay in the hospital for several days. You may be prescribed antibiotics to prevent infection. Post-surgery, you will need to return to your doctor’s office for a follow-up visit. During this visit, the stimulator will be turned on and programmed to provide the specific level of stimulation you require.

Most people who have neurostimulator treatment have a significant improvement in symptoms and an improved quality of life. However, you may still require medication to manage symptoms such as seizures.