Insufficient Charge; Noise, Artifacts, Poor Signal Displayed, Or No Signal Displayed In Real-Time Ecog - Neuropace RNS System User Manual

Troubleshooting
Troubleshooting During a Routine Follow-up
1. Repeat lead impedance measurements to verify abnormal lead impedance.
2. Take an image (X-ray or CT scan) of the implanted lead(s) and connector cover to discern
the integrity of the lead.
Lead Damage – If the lead is damaged or fractured, it is recommended to abandon and
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replace the lead. Refer to the Changing the Leads that are connected to the
Neurostimulator section of this manual.
Poor Connection – If the lead is not completely installed in the connector cover, it is
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recommended to surgically revise the connection between the connector cover and
lead. Refer to the Changing the Leads that are connected to the Neurostimulator
section of this manual.
Note: It is normal for lead impedance measurements to fluctuate following the implant
procedure due to the acute injury and healing processes of the brain tissue.
Note: Lead damage may not be immediately apparent from the real-time ECoGs. Using the
N
OISE

Insufficient Charge

Insufficient charge occurs when the neurostimulator is unable to fully deliver the programmed
therapy. It may be due to high lead impedance or the neurostimulator configuration settings. If the
first entries in the PDMS interrogation report event list show the "Programmed current" is higher
than the "Lowest delivered" current (as shown in the example image) contact your NeuroPace
Field Clinical Engineer. The NeuroPace Field Clinical Engineer will help you review the lead
impedances and neurostimulator configuration settings to determine the cause.

Noise, Artifacts, Poor Signal Displayed, or No Signal Displayed in Real-time ECoG

Troubleshooting During an Intraoperative Procedure
1. If no ECoG signal is seen, make sure lead labels and montage have been programmed.
2. If the signal is too high in amplitude or saturating, decrease the gain setting.
3. If the leads are positioned over the RNS
neurostimulator.
4. Remove the connector cover from the RNS
5. Flush the connector cover (with leads inserted) and the RNS
area with saline.
6. Remove the leads from the connector cover. Clean the proximal end of the lead with saline
and visually inspect that the lead end is free of excess blood or other tissue.
7. Reinsert the leads. Verify that they are fully inserted into the connector cover ports.
8. Place the connector cover back onto the RNS
leads are fully inserted in the connector cover ports.
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RNS System User Manual
ECoG storage trigger may be helpful in future troubleshooting techniques.
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Neurostimulator, move them away from the
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Neurostimulator using the torque driver.
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Neurostimulator connector
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Neurostimulator. Verify, once again, that the
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