Seizures happen when there is unusual electrical activity in the brain. About one in three people with epilepsy do not find relief with just medications or have side effects from medications that affect their quality of life. For some patients, surgery to remove a part of the brain, which is causing seizures, might be an option. This is not suitable for everyone.
This page has been written for patients who wish to find out more about a new procedure for epilepsy that does not involve removing parts of brain, known as EASEE® (Epicranial Application of Stimulation Electrodes for Epilepsy). This device is already approved for use in the NHS but is new to UCLH Trust.
Doctors now know that electrical stimulation devices are effective in helping some patients controlling their seizures. EASEE® is one such device. About 5 cm long, it is placed under the scalp through a cut in the skin on your head. The device sends electrical pulses to the area of the brain where seizures start. The generator will be placed on your chest and will require another cut in the skin. This helps control seizures without needing to remove brain tissue or open the skull bone.
The device is thin and discreet, and patients should not feel it while going about their daily activities. EASEE® uses different types of electrical pulses to both help reduce seizures and stabilize brain activity to prevent future attacks.
EASEE® is meant to be used alongside your medication to help reduce seizures and stabilize brain activity over time. In a 2023 trial, patients saw a reduction in their seizures after using EASEE® by about one-third at 1 year and 68% after 18-24 months. There were no serious complications related to the insertion of the device such as death or permanent neurological deficits such as problem with speech, movement, memory or vision.
You might be recommended this treatment if:
- You have tried several medications that did not work.
- Your seizures come from one focused area of the brain.
- You are not suitable for surgical resection of the brain area where the seizures start.
All treatments and procedures have risks and we will talk to you about the risks of EASEE®.
Problems that may happen straight away
- Bleeding: Some swelling or pain may happen at the wound areas but usually resolves on its own.
Problems that may happen later
- Wound healing issues, including infection: This might require antibiotics or even removal of the device.
- Movement of the electrode or disconnection of wiring: If the electrode shifts or any part disconnects, you may need another procedure to reposition/reconnect it.
- Need for further treatments: Sometimes seizures may still occur, requiring additional treatments. If the device is proven to be effective the battery will need to be changed by re-opening the chest wound. The battery is designed to last for several years. How long it will last will also depend on the settings of the device that you need.
- You can have MRI scans even after the device is implanted. However, you should always notify the MRI department about the device as there will be safety precautions.
Problems that are rare, but serious
There is a small risk of severe problems arising from general anaesthesia. Risks such as heart attacks or strokes is less than one in 1000 patients. Risk of death affects less than one in 10000 patients. Risks may be increased depending on any chronic health illnesses you may have. The risks will be discussed with you before the operation by the anaesthetist.
You may continue to have uncontrolled seizures if the alternatives do not work for you or if they are not suitable options. Continued seizures can affect your mental function and overall quality of life. You can speak to your managing specialists about this.
There are various treatments for epilepsy, including medications, surgery, radiosurgery, laser treatment and other procedures using electrical stimulation such as vagal nerve stimulation and responsive neurostimulation therapy. Your doctor will recommend the best option after they have looked at the following factors:
- Suitability of your epilepsy for surgical resection
- Cause of your epilepsy
- Overall seizure control and effects of your epilepsy on quality of life
- Any previous treatment
- Your general health
- You cannot have any food for 6 hours before your procedure time.
- Wash as usual or with Hibiscrub wash if given to you.
- You can sip water up until the time of your surgery.
- Take all your usual medication with 2 glasses of water, unless you have been told otherwise by the nurses in the Pre-Assessment Clinic. Remember to bring all your medication with you in the original boxes/bottles. It is especially important to remember to bring any asthma inhalers or angina sprays with you.
- Remove make up, nail varnish, acrylic nails, false eyelashes, body studs and tongue piercings. Do not wear or bring in jewellery (wedding bands can be taped over).
Following your general anaesthetic, you must not drive, drink alcohol or operate machinery for a minimum of 24 hours. This may be longer following certain types of surgery. After this time, you should only resume these activities when you feel able to.
If you are going home within 24 hours of your operation, you must have someone to take you home and stay with you for the 24 hours. Most patients should be able to go home by the next day.
If you have haemophilia, please phone the Epilepsy Surgery Unit for specific advice. If you are taking Warfarin, Clopidogrel, Dabigatran, Rivaroxaban, Apixaban, Edoxaban, or other blood thinning medications, please tell us at least one week before your procedure.
If you have a pacemaker or an implantable cardioverter defibrillator please tell us when you accept the procedure.
We want to involve you in all the decisions about your care and treatment. If you decide to go ahead with treatment, by law we must ask for your consent and will ask you to sign a consent form. This confirms that you agree to have the procedure and understand what it involves. Staff will explain all the risks, benefits and alternatives before they ask you to sign a consent form. If you are unsure about any aspect of your proposed treatment, please do not hesitate to speak with a senior member of staff again.
The EASEE® device is implanted while you are asleep under general anaesthesia. The procedure involves two small cuts: one on your head for the electrode and one on your chest for the battery. We will need to shave some of your hair around the area of the skin incision on the head. A small tunnel is created under the skin to connect the wires between the electrode on the skull and the battery in the chest. The tunnelling may require a small cut behind your ear. The surgery takes about 1.5 hours, and there is no need to remove any skull bone or touch the brain.
After surgery, you may experience pain/ discomfort in the areas where the device has been placed. Pain will respond to pain killers such as paracetamol.
The wound is expected to heal within 7-10 days. If you experience worsening swelling and pain or persistent fluid coming out from the wound, go to the nearest Accident and Emergency Department or notify your surgical team.
You will need to continue reviews with your specialist doctors at 3 months, then 6 months. As every patient is different, it may take a few months to notice effects. Sometimes, the electrical impulse settings might need to be adjusted for better results.
You can visit the following website for more information on EASEE device: https://
UCLH cannot accept responsibility for information provided by other organisations.
Haneef, Z., Yang, K., Sheth, S.A., Aloor, F.Z., Aazhang, B., Krishnan, V. and Karakas, C., 2022. Sub-scalp electroencephalography: A next-generation technique to study human neurophysiology. Clinical Neurophysiology, 141, pp.77-87.
Schulze-Bonhage, A., Hirsch, M., Knake, S., Kaufmann, E., Kegele, J., Rademacher, M., Vonck, K., Coenen, V.A., Glaser, M., Jenkner, C., Winter, Y., Groppa, S. and EASEE Study
Group, 2023. Focal cortex stimulation with a novel implantable device and antiseizure outcomes in 2 prospective multicenter single-arm trials. JAMA Neurology, 80(6), pp.588-596.
Schulze-Bonhage, A., Nitsche, M.A., Rotter, S., Focke, N.K. and Rao, V.R., 2024. Neurostimulation targeting the epileptic focus: Current understanding and perspectives for treatment. Seizure, 117, pp.183-192.
Precis-GmbH, 2023. MRI Safety Guidelines for EASEE System ESC003 (Version 3.0). Retrieved from https://
Hospital no: 020 3456 7890 or 0845 155 5000
Epilepsy nurse specialist advice line (office hrs only): 020 3448 8627
Epilepsy nurse specialist email: uclh.
Epilepsy surgery coordinator: 020 3448 8616
Epilepsy fax no: 020 3448 8615
Neurosurgery (secretary): 020 3448 3393
On-call neurosurgery SpR: 0845 155 5000, Bleep 8100
Website: www.
Epilepsy Department, Box 29, National Hospital for Neurology and Neurosurgery, London, WC1N 3BG
Epilepsy : University College London Hospitals NHS Foundation Trust (uclh.nhs.uk)
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Page last updated: 04 March 2025
Review due: 01 March 2027