Neuromodulation for Epilepsy

VNS, RNS, and DBS

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If medications haven’t provided satisfactory relief from seizures and resective epilepsy surgery (removing the area of the brain where your seizures originate) isn’t ideal for you, implantable neuromodulation devices may help prevent or reduce your seizures. Our team of neuromodulation experts work closely with you to recommend the best device, maximize its benefit over time, and reduce side effects.

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About Neuromodulation for Epilepsy

Neuromodulation devices use low-current electrical impulses to prevent or interrupt seizure activity in the brain. They consist of a generator (a battery) and one or more electrodes that are placed in the neck or brain. Once implanted, these devices typically aren't noticeable or bothersome and can remain in place for your lifetime.

Neuromodulation devices can reduce the number, length, and severity of seizures, as well as recovery time after a seizure. When used in the right candidates, neuromodulation has a high success rate, few side effects, and relatively low risks.

Our Locations

Duke Health offers locations throughout the Triangle. Find one near you.

Types of Neuromodulation Devices

There are three FDA-approved neuromodulation devices for epilepsy. Some people qualify to have more than one device implanted.

Vagus Nerve Stimulation (VNS)
A VNS generator is implanted under the collar bone. A thin wire connects it to the left vagus nerve in your neck, which transmits messages to your brainstem. On a schedule, the device delivers weak electrical pulses to the brain that help prevent seizures.

Responsive Neurostimulation (RNS)
An RNS generator is implanted into the skull and connects to electrodes placed directly on or in the brain. It monitors your brain activity, and when it identifies abnormal patterns that could lead to a seizure, it sends small electrical currents to prevent or interrupt them.

Deep Brain Stimulation (DBS)
A DBS generator is implanted under your collar bone. Two small wires connect it to targeted areas of the brain, where electrical signals are delivered on a schedule and help stop seizures from beginning or spreading.

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Duke's Advanced Neuromodulation Program

Our neuromodulation specialists in Durham and Raleigh offer consultation services to determine which device is right for you, and comprehensive follow-up care after the device is implanted. Our providers have the technical expertise and experience required to adjust your device, minimize side effects, and maximize its benefits. Frequent scheduled visits allow you to ask questions along the way.

Level 4 Epilepsy Center - Adult

As a Level 4 Epilepsy Center, Duke Health provides the highest level of diagnosis, medical, and surgical treatments for people with epilepsy. It is one of the reasons why Duke University Hospital’s neurology and neurosurgery program is nationally ranked, and the highest-ranked program in North Carolina, according to U.S. News & World Report in 2024-2025.

This page was medically reviewed on 03/12/2024 by