Responsive Neurostimulation (RNS) is a relatively recent addition to the epilepsy surgery armory, gaining FDA approval in 2013 for use in adults with intractable focal epilepsy [1]. There have been at least 9 years of data evaluating the safety and efficacy in adult patients [2]. RNS is not yet approved for use in Europe, or for pediatric patients less than 18 years of age in the United States. Options of neurostimulation include vagus nerve stimulation (VNS), responsive neurostimulation, deep brain stimulation (DBS), chronic subthreshold cortical stimulation (CSCS), transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) [3], although VNS is the only modality that is FDA approved for use in the pediatric population. Neurostimulation for these devices has traditionally been administered in an open-loop manner where stimulation output is constant; in contrast, RNS uses a closed loop system, where electrodes continually sample cortical electrographic activity and are programmed to provide high frequency abortive neurostimulation when abnormal electrographic activity is detected [4].
DIC