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

Neurol Ther https://doi.org/10.1007/s40120-026-00964-6 ORIGINAL RESEARCH Clinical Characteristics, Treatment Patterns, and Drug‑Resistant Epilepsy Among Emirati Adults with Epilepsy Mahra Alhammadi · Bayena Khamis Alblooshi · Amal Ahmed · Mohammad Alshaer · Raya Almazrouei · Saif Al‑Shamsi Received: March 10, 2026 / Accepted: May 11, 2026 © The Author(s) 2026 ABSTRACT Introduction: Detailed clinical descriptions of treated adult epilepsy in the Arab region remain scarce. We examined epilepsy type, antiseizure medication (ASM) use, comorbidi‑ ties, and drug-resistant epilepsy (DRE) in Emi‑ rati adults with epilepsy in the United Arab Emirates (UAE). M e t h o d s : We c o n d u c t e d a r e t r o s p e c ‑ tive 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 under‑ went chart review. Epilepsy type was classi‑ fied using 2017 International League Against Mahra Alhammadi, Bayena Khamis Alblooshi, Amal Ahmed and Mohammad Alshaer have contributed equally to this work. M. Alhammadi · B. K. Alblooshi · A. Ahmed · M. Alshaer · R. Almazrouei · S. Al‑Shamsi (*) Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, PO Box 15551, Al Ain, United Arab Emirates e-mail: R. Almazrouei Division of Endocrinology, Tawam Hospital, Al Ain, United Arab Emirates 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. Results: 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 dia‑ betes mellitus (12.7%) were the most common comorbidities. DRE was identified in 36/150 patients (24.0%) with available prior ASM fail‑ ure data and in 36/204 patients (17.6%) in the full cohort. Conclusions: 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. Cardiometa‑ bolic comorbidities were common. DRE was seen in nearly one in four patients with avail‑ able 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. Vol.:(0123456789) Neurol Ther PLAIN LANGUAGE SUMMARY Epilepsy is a brain condition that can cause repeated seizures. Many people become sei‑ zure-free with antiseizure medicines, but some continue to have seizures despite trying sev‑ eral treatments. Detailed information on how adults with epilepsy are treated in the Arab region remains limited. We reviewed the elec‑ tronic 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 per‑ son had drug-resistant epilepsy. Drug-resistant epilepsy means that seizures continue despite treatment with at least two appropriate and tol‑ erated antiseizure medicines. We included 204 adults (median age 34 years; 55.9% male). Epi‑ lepsy 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 antisei‑ zure 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 informa‑ tion on previous treatment failures, 36 (24.0%) had drug-resistant epilepsy. This corresponded to 17.6% of the full cohort. This study adds clin‑ ical data on adults with epilepsy from an under‑ represented 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 com‑ mon. 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 documen‑ tation and for larger studies in the United Arab Emirates and the wider Arab region. Keywords: Epilepsy; Drug-resistant epilepsy; Antiseizure medications; Clinical epidemiology; Comorbidities; United Arab Emirates Key Summary Points Why carry out this study? Epilepsy is a common neurological condi‑ tion, but detailed clinical data on treated adult epilepsy in the Arab region remain limited. Drug-resistant epilepsy, defined as ongoing seizures despite trials of at least two appropri‑ ate antiseizure medicines, remains an impor‑ tant unmet need in routine care. This study described epilepsy types, treat‑ ment patterns, comorbidities, and the fre‑ quency of drug-resistant epilepsy among Emi‑ rati adults with epilepsy attending a tertiary center in the United Arab Emirates. What was learned from the study? Among 204 adults (median age 34 years; 55.9% male), epilepsy type was specified in 178; among these patients, generalized epi‑ lepsy was more common than focal epilepsy (66.9% vs. 33.1%). Monotherapy was the most common recorded treatment pattern (66.7%), most often with levetiracetam (50.0% of the full cohort). Drug-resistant epilepsy was present in 36/150 patients (24.0%) with enough information on previous treatment failure, and in 36/204 patients (17.6%) in the full study group. It was seen in patients taking one antiseizure medicine and in those taking more than one, because drug-resistant epilepsy is defined by failure of previous treatments, not by the number of medicines a patient is taking now. Cardiometabolic comorbidities were com‑ mon, particularly dyslipidemia (38.7%) and type 2 diabetes (12.7%), supporting the need for more integrated epilepsy and chronic dis‑ ease care in the United Arab Emirates. Neurol Ther INTRODUCTION Worldwide, epilepsy is a major cause of disability and premature death [1] and contributes sub‑ stantially to healthcare costs and loss of produc‑ tivity [2]. It is a neurological disorder character‑ ized by a persistent tendency to have epileptic seizures due to abnormal neuronal activity [3]. Although seizures occur intermittently, (...truncated)