Implanted Devices for Management of Drug-Resistant Epilepsy: Background and MR Imaging Considerations

Advances in the field of neuromodulation provide patients with medically refractory epilepsy without surgical options the possibility of effective alternative treatments. Three FDA approved electronic neuromodulation devices now exist, vagal nerve stimulation (VNS), responsive neurostimulation (RNS), and deep brain stimulation (DBS). MRI plays a central role in defining stimulation targets. Essential MR safety conditions must be strictly adhered to. Some situations require off-label MR scanning, such as the presence of more than one neuromodulation system or during MR guided therapy, (eg, laser interstitial thermal ablation). Active engagement of well-trained MR safety expert MR physicists is essential in these scenarios.