Authors :
Presenting Author: Nikol Agadzhanian, MSc – Yale University, Yale School of Medicine
Jayanth Tallapalli, – Yale University
Rohith Nelakurthi, MD – Yale
Luke whitmire, PhD – Epitel Inc.
Mark lehmkuhle, PhD – Epitel Inc.
Aline Herlopian, MD – Yale
Rationale:
Remote EEG monitoring systems are novel platforms allowing wireless recordings of brain activity. Consisting of only four small sensors, they represent the future of diagnostic neurology. Traditional ambulatory electroencephalography (aEEG) monitoring is limited to 3-day periods, which may miss opportunities to capture infrequent seizures or events in patients with questionable seizure characterization. Extended monitoring capabilities are needed to improve diagnostic yield and clinical decision-making while providing patients minimal discomfort and easy mobility during recording.
Methods:
This prospective study evaluated 20 patients undergoing Epitel's Remote EEG Monitoring System (REMI™) for extended ambulatory monitoring (14-28 days) with concomitant traditional aEEG in the first three days of recording. Primary outcome assessed REMI's ability to record clinically evaluable EEG data over extended periods, reviewed by three independent board-certified epileptologists. Secondary outcomes included extended system usability, treating clinician assessment of clinical value, patient quality of life, and adverse events.
Results:
Twenty-one patients completed monitoring with a mean duration of 26.4 ± 4.0 days (634.2 ± 96.8 hours). Among 13 subjects with completed EEG analysis, diagnostic yield was achieved in 69.2% (9/13), successfully meeting referral objectives (e.g, spell characterization or changes in therapeutic intervention, such as surgical intervention versus continued medical management). High satisfaction was reported in 90.0% (18/20) of patients, and 95.0% (19/20) would recommend the system to others. Also, 100% (20/20) preferred REMI over the traditional EEG due to comfort, ease of use, freedom to be mobile, and lack of sleep disruption. Extended monitoring enabled diagnostic clarification in multiple cases as illustrated in Figure 1. Most patients (70.0%) successfully self-applied the system, while 30.0% required caregiver assistance. Adverse events occurred in 80.0% of subjects (Figure 2), primarily consisting of mild skin irritation and adhesive-related issues. All adverse events were manageable without any necessity for study discontinuation.
Conclusions:
The REMI system demonstrated excellent patient acceptance and tolerability, and future studies will further enhance patient selection criteria, maximize diagnostic yield, and define the clinical scenarios where this technology can deliver the greatest value and maximum diagnostic benefit.
Disclaimer: Analysis is ongoing for the remaining subjects. Full analysis will be completed and available before AES 2025, if accepted.Funding: Epitel Inc.