What is neuromodulation?
Neuromodulation uses mild electrical pulses to change the way nerve cells communicate with each other. This can prevent or lessen seizures in children with epilepsy and reduce muscle spasms in children with movement disorders like dystonia. It is used along with other treatments (this is called adjunctive treatment).
Neuromodulation may be a good choice for your child if other treatments do not control their epilepsy or dystonia. Neuromodulation reduces seizures and muscle spasms but does not completely stop them.
During a surgery, a neurosurgeon places a device in your child’s body and connects it via tiny wires to specific areas of their brain or to the vagus nerve just below the brainstem. Like a pacemaker, the device will not be visible after placement. A neurologist adjusts settings on the device for the best results for your child.
What is the Neuromodulation Program?
Our Neuromodulation Program brings together an expert team to diagnose and treat your child’s seizures or movement disorder. At our monthly program in Seattle, children can get all their care in 1 setting.
We offer 3 types of neuromodulation treatment:
- Responsive neurostimulation (RNS) for epilepsy
- Deep brain stimulation (DBS) for epilepsy and movement disorders
- Vagus neurostimulation (VNS) for epilepsy
Why choose Seattle Children’s Neuromodulation Program?
We offer treatments that can be life-changing for children with seizures and movement disorders that are not controlled by other treatments.
Advanced treatments to improve your child’s quality of life
- We are one of a few centers in the country offering children options such as RNS and DBS
- We are the only provider in the Northwest that offers DBS and RNS for children.
- Studies have shown:
- With DBS treatment, most epilepsy patients had half as many seizures. Children with movement disorders had a significantly improved quality of life.
- With RNS, 60% to 70% of patients had a significant reduction in the number and length of seizures.
The experts you need in 1 place
- Our large team includes experts in the brain and nervous system (neurologists), epilepsy, movement disorders, neurosurgery, and behavior and learning (neuropsychologists).
- The children we treat can get all their care in 1 setting at our monthly Neuromodulation Program. This avoids having multiple doctor visits across multiple days. We coordinate care so you can focus on your child.
- We work closely with Seattle Children’s Epilepsy Program, the largest program on the West Coast to treat babies, children and teens who have repeated seizures.
- Our program is part of Seattle Children’s Neurosciences Center, which ranks among the nation’s best neurology and neurosurgery programs.
Research to improve outcomes
- Our physician-scientists lead research in the lab and in the program to improve treatment and quality of life for children with seizures and movement disorders.
- We do research to identify which children will benefit most from neuromodulation therapies and how to optimize these therapies to ease symptoms.
- See Seattle Children’s Current Research and Clinical Trials. Search for epilepsy or seizure.
Services We Provide
We bring together an expert team to diagnose your child and provide cutting-edge, evidence-based therapies. We use 3 neuromodulation device options that send small electrical pulses into your child’s brain to improve their quality of life.
Comprehensive assessment of your child’s unique needs
During a complete evaluation, we monitor the electrical activity in your child’s brain and do brain imaging studies and neuropsychological testing. These tests help us find out more about your child’s seizures or movement disorder and the effect on your child.
While your child stays in our special monitoring unit for up to 1 week, we:
- Use EEG (electroencephalography) equipment, a painless way to record electrical activity in your child’s brain.
- Make video and sound recordings of your child to see and hear what happens when they have a seizure or muscle spasm.
- Use brain imaging techniques such as MRI scans, PET scans and SPECT. These images, along with neuropsychological testing, help us see patterns of behavior and movement and find the area of your child’s brain where harmful electrical activity starts.
This full assessment helps us recommend the best neuromodulation options for your child.
To learn more, see Tests to See If Epilepsy Surgery Is Right for Your Child (PDF) (Spanish) (Somali) (Vietnamese)
Vagus nerve stimulator (VNS)
VNS helps prevent seizures by sending a small, on-and-off electrical pulse to the vagus nerve. The vagus nerve starts in the brainstem (just below the brain) and goes down the neck and into the chest. Some people think of VNS like a pacemaker for the brain.
During surgery, the neurosurgeon puts the stimulator under the skin on the left side of your child’s chest. The device is about the size of a bottle cap. After the area heals, your child’s provider sets the device using a wand connected to a computer.
Most often, the device works on its own to stop seizures. But if your child senses the start of a breakthrough seizure, you or your child can place a small, handheld magnet over the spot where the device is located. This provides on-demand stimulation to stop the seizure.
The U.S. Food and Drug Administration (FDA) has approved VNS for children at least 4 years old. We have placed over 70 VNS devices in children and care for well over 200 patients with these devices.
- Read more about Vagus Nerve Stimulator (VNS): A Treatment for Drug-Resistant Epilepsy (PDF) (Pashto) (Spanish) (Somali) (Vietnamese)
Deep brain stimulation (DBS)
In DBS, a small battery-powered device, like a pacemaker, sends low-level electrical signals to specific areas in your child’s brain. The device helps control seizures and muscle spasms to improve your child’s quality of life.
Seattle Children’s is the only provider in the Northwest to offer DBS for children.
We also have used DBS to reduce symptoms in children with rare genetic disorders such as Lesch-Nyhan, which causes some children to harm themselves.
During surgery, the neurosurgeon places the device under the skin in your child’s chest and puts 2 thin electrical wires into the deep brain tissue where seizures start.
A few weeks after surgery, your child’s neurologist programs the device to determine how often and how much to stimulate your child’s brain. It will take several clinic visits to decide the right settings needed to control your child’s seizures or muscle spasms while minimizing side effects.
The neurologist can adjust the device as needed by using a remote control. Adjustment does not require surgery.
We will give you a device like a smartphone to adjust stimulation and track symptoms at home.
DBS can work on its own or be combined with VNS to reduce seizures and treat movement disorders.
Responsive neurostimulation (RNS)
In RNS, a battery-powered device monitors your child’s brain waves and sends a signal when it senses that a seizure may be starting. The signal stops the seizure. A neurosurgeon places the device in your child’s skull and connects thin wires from the device to 1 or 2 parts of the brain where your child’s seizures start.
A doctor who specializes in epilepsy (epileptologist) will program the device during a follow-up clinic visit.
We will give you a small wand and computer tablet. Use the wand to download information from the RNS device to the tablet each day. Once a week, upload the data on the tablet to an online database. This database gives your child’s epilepsy doctor vital information about how often your child has seizures and their brain wave activity.
- Innovative Epilepsy Procedure Offers New Avenue of Treatment to Reduce Seizures for a child whose seizures continued after trying medicine, diet and other surgeries.
- Responsive Neurostimulation System (RNS): A Treatment for Drug-Resistant Epilepsy (PDF) (Spanish) (Somali) (Vietnamese)
Conditions We Treat
Neuromodulation may be a good choice for children with:
- Epilepsy, if medicine and diet therapy do not control their seizures and if surgery to remove brain tissue is not an option
- Dystonia and other movement disorders that are not helped enough by medicine (pills or Botox injections) and rehabilitation therapies
- Rare genetic disorders such as Lesch-Nyhan, which causes some children to hurt themselves through lip and finger biting
Schedule an Appointment With the Neuromodulation Program
- If you would like a referral to the Neuromodulation Program, talk to your child’s healthcare provider.
- If you have a referral, see how to schedule an appointment.
- If you already have an appointment, learn more about how to prepare.
- Learn about resources such as useful websites, videos and recommended reading for you and your family.
Providers, see how to refer a patient.