Clinical Characteristics, Treatment Patterns, and Drug-Resistant Epilepsy Among Emirati Adults with Epilepsy

Detailed clinical descriptions of treated adult epilepsy in the Arab region remain scarce. We examined epilepsy type, antiseizure medication (ASM) use, comorbidities, and drug-resistant epilepsy (DRE) in Emirati adults with epilepsy in the United Arab Emirates (UAE).

We conducted a retrospective cohort study of Emirati adults aged 18-65 years attending neurology clinics at a tertiary center in Al Ain between January 2019 and January 2024. Patients were screened from neurology clinic visits, and those with at least one G40.909 coded encounter underwent chart review. Epilepsy type was classified using 2017 International League Against Epilepsy frameworks. DRE was defined as failure of at least two appropriately chosen and tolerated ASMs. Clinical and treatment data were extracted from electronic medical records.

The cohort included 204 adults [median age 34 years (26.0-44.2); 55.9% male]. Epilepsy type was specified in 178/204 patients; among whom generalized epilepsy was more common than focal epilepsy (66.9% vs. 33.1%). Monotherapy was the most common recorded treatment pattern (66.7%), and levetiracetam was the most frequently prescribed ASM (50.0%). Dyslipidemia (38.7%) and type 2 diabetes mellitus (12.7%) were the most common comorbidities. DRE was identified in 36/150 patients (24.0%) with available prior ASM failure data and in 36/204 patients (17.6%) in the full cohort.

This study adds data on adult epilepsy from an underrepresented Emirati population. Most patients were treated with ASM monotherapy, and levetiracetam was the most commonly prescribed drug. Cardiometabolic comorbidities were common. DRE was seen in nearly one in four patients with available prior ASM failure data, while the lower estimate in the full cohort was at least one in six patients. These findings highlight the need for better clinical documentation and for larger multicenter studies in the UAE and the wider region.