The NeuroPace RNS System is a responsive neurostimulator for epilepsy that medication has not controlled. A small device is placed in the skull and connected to one or two thin leads positioned where that person’s seizures begin.
The device watches brain activity day and night. When it recognizes the pattern that comes before a seizure, it sends brief electrical pulses to interrupt it. Stimulation adds up to only about three minutes a day on average, and most patients do not feel it. The device also records brain data that you upload from home, which gives the epilepsy team an objective record instead of relying on a seizure diary.
The RNS System is approved in the United States for adults 18 and older with focal epilepsy coming from one or two places in the brain, who still have seizures after trying at least two anti-seizure medications. It is often chosen when the seizure focus sits in an area that cannot safely be removed, when there are two separate foci, or when earlier epilepsy surgery did not work. No brain tissue is removed.
The implant is placed under general anesthesia in an operation that takes roughly two to four hours, with a hospital stay of one to three nights. Recording starts right away, but stimulation is usually switched on two to four weeks later, once you have healed. Settings then start low and are adjusted over a series of visits while the team reviews your uploaded data. Most people are back to work or school within two to four weeks. The battery lasts on the order of eight to eleven years depending on settings, and replacing it is a smaller operation that keeps the original leads.
Results build over time rather than appearing at once. In the long-term study of 230 patients published in Neurology in 2020, the median reduction in seizures was 55% at three years and 75% at nine years, and 73% of patients had at least a 50% reduction. In a later post-approval study of 324 patients, reported in 2025, the median reduction was 82% at three years and 42% of patients had a seizure-free stretch of six months or more. These are different groups of patients studied in different periods, so the numbers should not be read as one continuous line.
Reported risks include infection at the implant site, bleeding in the brain, lead damage or the need for revision surgery, and seizure-related injury. The device is adjunctive: most patients stay on anti-seizure medication, sometimes at a lower dose.
Will I feel the stimulation? Most patients do not once the settings are dialed in.
Will it cure my epilepsy? No. It reduces seizure frequency and severity for many patients, and some go through long seizure-free stretches.
Can I have an MRI? The current neurostimulator is MR Conditional, meaning scans are allowed under specific conditions. Older models are not.
Sources: NeuroPace; National Institute of Neurological Disorders and Stroke; Cleveland Clinic; Nair et al., Neurology (2020); RNS post-approval study data presented in 2025.
To ask whether the RNS System fits your situation, call (561) 433-4444. Related: vagus nerve stimulation and laser ablation (LITT).
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