Responsive neurostimulation (RNS) was FDA-approved in 2013 as adjunctive therapy for refractory epilepsy. RNS is different from VNS and DBS in that treatment is designed to abort seizures when they happen. This is done by sensing wires with electrode contacts placed within specific seizure-producing areas in the brain that detect seizures as they arise, and deliver small electric current stimulation to stop or slow them. RNS therapy can be a valuable addition to treatment options available for patients who continue to experience seizures despite optimum drug treatment, though full benefits may take months or years to accrue. As with all complex patients, patients who may benefit from RNS are first vetted at our multidisciplinary patient management conference for their suitability. Following a consensus decision to proceed with RNS, the patient is counseled and scheduled for the procedure. The insertion of the RNS itself involves surgery under general anesthesia, where the stimulation wires are inserted into predetermined locations within the brain and the stimulator pack situated within the skull. Patient usually go home a day or two after the procedure, and subsequently attend the clinic for follow up where the settings of stimulation are gradually adjusted.