Background: Responsive Neurostimulation (RNS) has proven efficacy in the treatment of medically resistant epilepsy as an intracranial system that detects, records and treats seizures automatically. No information exists pertaining to artifact characteristics of RNS findings in scalp EEG. Methods: A 30 year-old female was diagnosed, using intracranial electroencephalography (iEEG), with refractory bi-insular epilepsy, of unknown cause. Due to her large number of focal unaware non-motor seizures and frequent seizures with progression to bilateral tonic-clonic, she was implanted with bi-insular Responsive Neurostimulation (RNS). Results: Results: During scalp EEG recordings, a prominent artifact was seen corresponding to an automatized discharge suspectedly evoked by the RNS trying to minimize the frequent epileptiform activity in her case. Figure 1 and 2 depict these findings. Conclusions: The artifact seen by the RNS in scalp EEG has not been previously described in scientific literature. These findings must be identified to better characterize the role of the RNS in EEG and treatment of seizure activity visible on scalp recordings.