Case Report: Clinical applications of extended-duration remote ambulatory EEG monitoring: lessons from real-world cases

Background Traditional ambulatory electroencephalography (EEG) and inpatient epilepsy monitoring unit (EMU) admissions face significant operational limitations including: short recording windows (typically 24–72 h), high costs, technician shortages, and physical restrictions on daily activities. Methods This article presents clinical utility frameworks and three illustrative real-world case studies utilizing the REMI Remote EEG Monitoring System—a wireless, wearable 4-sensor electrode-setup (10-channel EEG montage system) montage system integrated with cloud data transmission and post-acquisition artificial intelligence (AI) electrographic seizure detection algorithms. Results In Case 1, a 39-year-old female with suspected recurrent epilepsy experienced three focal seizures after the standard 72-h monitoring window, allowing initiation of targeted antiseizure therapy. In Case 2, extended monitoring in a 57-year-old male with long-standing epilepsy experiencing new exercise-induced symptoms ruled out electrographic seizures, avoiding unnecessary medication escalation. In Case 3, a 52-year-old male with worsening episodic déjà vu exhibited focal interictal rhythmic activity, providing objective data to guide shared decision-making and successful initiation of antiseizure treatment. Conclusion Extended-duration remote EEG monitoring bridges key diagnostic gaps by offering flexible, real-world data collection over extended timeframes (up to 30 days). This approach optimizes clinical triage, clarifies event etiology, and improves ambulatory epilepsy care without overburdening tertiary health care infrastructure.