Cleveland Clinic Abu Dhabi pioneers UAEs first SEEG procedure for epilepsy

• Cleveland Clinic Abu Dhabi’s Neurological Institute is the first Level 4 Epilepsy Service Center in the UAE, providing more complex forms of non-invasive and invasive neurodiagnostic evaluation. • SEEG uses advanced technology to implant thin electrodes directly into the brain without removing the skull, allowing precise targeting of seizure origins and fewer complications. • The epilepsy program at Cleveland Clinic Abu Dhabi has a multidisciplinary team that offers a holistic, disease-specific, patient-focused approach.

Cleveland Clinic Abu Dhabi, part of the M42 group, has successfully performed the UAE’s first stereoelectroencephalography (also known as stereotactic encephalography or SEEG) procedure, a minimally invasive surgical technique that pinpoints the origins of hard-to-treat focal epileptic seizures within the brain.

Epilepsy, a chronic disorder characterized by recurrent seizures due to abnormal synchronous electrical discharge from brain cells, affects millions globally. The World Health Organization estimates that approximately 5 million people are diagnosed with the condition each year, with active cases ranging between 4 and 10 per 1,000 individuals. While medications can control epilepsy in up to 70% of cases, the remaining 30% who do not respond fully to medication may require SEEG to better localize seizure origins through the surgical implantation of thin electrodes in the brain. These electrodes reach areas of the brain that are inaccessible with traditional techniques.

The pioneering procedure at Cleveland Clinic Abu Dhabi was performed on an Emirati patient, who had been battling epilepsy for over a decade. Preceded by multiple multidisciplinary discussions and days of meticulous planning, the complex surgery lasted several hours. The patient was subsequently monitored in a highly controlled environment at the Epilepsy Monitoring Unit for 10 days with the implanted leads in place. During that time, the patient’s seizures were captured spontaneously and localized to a specific region in the brain. In addition, electric current was administered through the implanted leads to trigger the patient’s specific seizures, further supporting the localization of the area from which the seizures were arising, known as the “epileptogenic zone”.

Dr. Florian Roser, Institute Chair, Neurological Institute at Cleveland Clinic Abu Dhabi, who led the team treating the patient, said, “If we cannot localize seizures with standard scalp EEG recording or other non-invasive imaging modalities, such as MRI, PET-CT, and ictal SPECT scans, then SEEG is necessary. This involves monitoring seizures from within the brain, as opposed to scalp monitoring. The challenge, however, lies in placing the electrodes deep within the brain without damaging vessels or critical structures. Our advanced software, unique in the UAE, integrates various imaging studies to plan the safest and most effective electrode placement.”

Dr. Eugene Achi, Staff Physician, Neurology, Neurological Institute at Cleveland Clinic Abu Dhabi, who leads a team of five epileptologists, emphasized the importance of early surgical intervention. “There are many studies which have shown that early surgical intervention can lead to better outcomes in terms of memory, quality of life, and overall success rate that goes up to 70%, depending on the case.”

Dr. Eugene also highlighted the multidisciplinary nature of the procedure, acknowledging the contributions of epileptologists, neurosurgeons, neuropsychologists, neuroradiologists, and nuclear medicine radiologists. “This achievement is a testament to our dedicated multidisciplinary team and the support from our institution, health authorities, and the patient and his family. We are proud of the outcome and grateful for the trust placed in us,” he added.

The successful completion of the UAE’s first SEEG procedure marks a significant milestone in the country’s medical advancements, offering new hope to patients with refractory epilepsy due to its reduced complications, less post-operative pain, and quicker recovery.

Cleveland Clinic Abu Dhabi’s Neurological Institute is the first Level 4 Epilepsy Center in the UAE. It provides complex neurodiagnostic monitoring and sophisticated imaging modalities, allowing for a comprehensive epilepsy surgical evaluation and an all-encompassing treatment plan for patients with intractable epilepsy.

For more information on Cleveland Clinic Abu Dhabi’s Neurological Institute, visit https://www.clevelandclinicabudhabi.ae/en/institutes-and-specialties/neurological

For more information on the SEEG procedure, visit https://www.clevelandclinicabudhabi.ae/en/health-hub/health-resource/treatments-and-procedures/who-should-be-evaluated-for-epilepsy-surgery

To book an appointment at Cleveland Clinic Abu Dhabi, call 800 8 CCAD (2223), visit www.clevelandclinicabudhabi.ae, or download the Cleveland Clinic Abu Dhabi Patient Portal app.