42-year-old woman with refractory epilepsy underwent a stereo-EEG evaluation in the Epilepsy Monitoring Unit and was found to have bilateral independent hippocampal onset seizures. Responsive neurostimulation (RNS) was implanted in those two locations. She is being followed in neuromodulation clinic. The patient reports a seizure with clinical features – she used her magnet to mark the event. Below is a picture of her EcoG from the magnet swipe. LHip represents the Left Hippocampus; RHip represents the Right Hippocampus. What is true about RNS and the above EcoG picture?

• RNS detects ictal activity only; seizure onset is in the right and left hippocampus
• RNS detects and treats ictal activity; seizure onset is in the right hippocampus
• RNS provides continuous stimulation; seizure onset is the right hippocampus
• RNS detects and treats ictal activity only; seizure onset is in the left hippocampus

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