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. Epilepsy is a brain condition that can cause repeated seizures. Many people become seizure-free with antiseizure medicines, but some continue to have seizures despite trying several treatments. Detailed information on how adults with epilepsy are treated in the Arab region remains limited. We reviewed the electronic medical records of Emirati adults aged 18–65 years who attended neurology clinics at a tertiary center in Al Ain, United Arab Emirates, between January 2019 and January 2024. We recorded epilepsy type, antiseizure medicines, other health conditions, and whether the person had drug-resistant epilepsy. Drug-resistant epilepsy means that seizures continue despite treatment with at least two appropriate and tolerated antiseizure medicines. We included 204 adults (median age 34 years; 55.9% male). Epilepsy type could be classified in 178 patients; among these, generalized epilepsy was more common than focal epilepsy (66.9% vs. 33.1%). Most patients were treated with a single antiseizure medicine (66.7%), and levetiracetam was the most commonly prescribed medicine (50.0% of all patients). Cardiometabolic conditions were also common, especially dyslipidemia (38.7%) and type 2 diabetes (12.7%). When we looked only at the 150 patients with enough information on previous treatment failures, 36 (24.0%) had drug-resistant epilepsy. This corresponded to 17.6% of the full cohort. This study adds clinical data on adults with epilepsy from an underrepresented Emirati population. Most patients were treated with one antiseizure medicine. Drug-resistant epilepsy was seen in nearly one in four patients with enough information on prior treatment failure, while the lower estimate in the full cohort was about one in six. High cholesterol and type 2 diabetes were also common. These findings should be interpreted with caution because the study was based on past medical records from a single center, but they highlight the need for better clinical documentation and for larger studies in the United Arab Emirates and the wider Arab region.