Responsive neurostimulation (RNS) is an epilepsy treatment that doesn't require the surgical removal of brain tissue. RNS使用一种植入的设备来帮助预防癫痫发作, similar to how a pacemaker detects and treats abnormal heart rhythms.
Responsive Neurostimulation
With RNS, 外科十大赌博平台排行榜在病人的头骨中植入了一个叫做神经刺激器的小型电池供电装置. The neurostimulator is connected to thin wires, called leads, 外科十大赌博平台排行榜在病人癫痫发作的大脑部位植入了哪个部位. The neurostimulator monitors the brain's electrical activity, and when activity that could lead to a seizure is detected, it delivers a pulse of electrical stimulation through the leads. The electrical pulse may stop the seizure before it begins.
Patients treated with RNS continue to take epilepsy medication, but their seizures may be better controlled than with medication alone. Because no brain tissue is removed, RNS poses less risk to the patient than other surgical treatments. 与传统的癫痫手术不同，RNS是可逆的，植入物可以随时移除.
The UCSF Epilepsy Center is one of the first centers on the West Coast to offer RNS. Our program uses a device called NeuroPace, FDA在2013年批准用于治疗难治性癫痫(药物控制不好的癫痫)的药物.
In clinical trials, 近一半的NeuroPace患者在植入一年后癫痫发作的频率下降了至少50%. The efficacy also appears to increase over time. 手术后三到六年，癫痫发作的中位数下降了60%或更多.
Who is a candidate?
如果您符合以下标准，您可能是RNS的好候选人:
- You have partial (focal) onset seizures.
- Your seizures originate in one or two areas of the brain.
- 即使在尝试了两种或更多种抗癫痫药物后，您的癫痫发作频繁且致残.
如果你的癫痫发作发生在大脑中负责语言或运动等关键功能的区域，RNS可能是其他手术治疗的一个很好的选择, 使手术切除引起癫痫的组织变得困难或不可能.
A team of neurologists, 神经外科十大赌博平台排行榜和其他癫痫专家将检查你的具体情况，以确定你是否适合进行RNS手术.
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Procedure
在手术前，你将接受诊断测试，以确定癫痫发作源自大脑的哪个部位. 手术小组将根据结果决定使用多少导联以及将它们放置在大脑的哪个位置.
The implantation procedure generally takes three to four hours. 外科十大赌博平台排行榜将在头皮和颅骨上做至少一个切口来放置神经刺激器和导线. 放置导线的切口通常只有四分之一的大小，但也可能更大. 神经刺激器通常植入一侧和头部后部.
该设备在手术室开启，最初的程序只用于记录大脑活动, without delivering electrical stimulation. 该设备将被编程为在对中心的后续访问中提供响应性刺激.
大多数病人在十大赌博平台排行榜住一晚，第二天就出院了.
Recovery
About 10 to 14 days after surgery, 你将去癫痫中心检查你的切口愈合情况以及记录的癫痫发作次数. 然后，十大赌博平台排行榜会对设备进行编程，以便在检测到异常的大脑活动时提供刺激. 神经刺激器还会继续收集你大脑活动的数据.
Most patients don't feel the electrical pulses. 如果你确实感到头痛或头皮有短暂的刺痛感, 请通知你的十大赌博平台排行榜，以便调整神经刺激器的设置.
手术后四到六周你会回到癫痫中心, and every three months thereafter, to monitor how the RNS is working. It can take as long as a year to see the full effects of RNS, and the frequency of seizures appears to continue to decline over time.
你会得到一个远程监视器，允许你从神经刺激器收集数据并将其发送给你的十大赌博平台排行榜. 你的十大赌博平台排行榜将使用这些数据在以后的访问中微调系统的设置. 该系统还包括一块磁铁，当你在癫痫发作时在植入部位滑动神经刺激器时，它会指示神经刺激器记录大脑活动. You can also use the magnet to temporarily stop the stimulation.
You will receive a wallet-sized medical implant identification card. Please carry this card with you at all times. 在通过机场或其他地方的安检系统时，你需要出示它.
After the device is implanted, 你必须避免某些可能导致能量通过设备传输到大脑的药物治疗, leading to brain injury or death. 这些包括核磁共振、透热、电休克疗法和经颅磁刺激.
神经刺激器的电池一般可以使用两年半到四年. 当你的电池电量不足时，你需要通过手术更换神经刺激器. Unless the leads also need to be replaced, the new neurostimulator will be connected to the same leads.
欲了解更多信息，请十大赌博平台排行榜的癫痫专科护士:
Neurology:
Maritza Lopez, (415) 353-2134
Neurosurgery:
Mariann Ward, (415) 353-2347
UCSF Health medical specialists have reviewed this information. 它仅用于教育目的，并不打算取代您的十大赌博平台排行榜或其他医疗保健提供者的建议. 我们鼓励您与您的供应商讨论您可能遇到的任何问题或疑虑.
Minimally invasive treatments for epilepsy
Learn more about surgical treatment options for epilepsy from Dr. Edward Chang, chair of neurological surgery at UCSF.
