Photo Credit: Jitendra Jadhav

The following is a summary of “Epilepsy in Patients With Primary CNS Lymphoma Prevalence, Risk Factors, and Prognostic Significance,” published in the August 2024 issue of Neurology by Aboubakr et al.

Epilepsy mainly occurs in patients with brain tumors, but specific data on its prevalence, onset, and risk factors in primary CNS lymphoma (PCNSL) remains limited. 

Researchers conducted a retrospective study determining the prevalence of epilepsy in PCNSL, further identifying risk factors associated with epilepsy and investigating the prognostic impact of seizures. 

They conducted a study at a tertiary neuro-oncology center (2011–2023) on immunocompetent patients with PCNSL with no prior seizures, analyzing clinical, imaging, and treatment data to determine epilepsy prevalence as a primary outcome and to identify clinical, radiologic, and treatment-related factors that were associated with epilepsy. Statistical analyses included χ² tests, t-tests, and logistic regression.

The results showed 330 patients, with 157 (47.6%) male and a median age at diagnosis of 68 years. The median Karnofsky Performance Status score was 60. Among the patients, 83 (25.2%) experienced at least 1 seizure from the initial diagnosis to the last follow-up, 40 (12.1%) as the onset symptom, 16 (4.8%) during first-line treatment, 27 (8.2%) at tumor progression, and 6 (1.8%) while in remission. Focal-aware seizures were the most common, occurring in 43 (51.8%). Seizure freedom under antiseizure medication was observed in 97.6%. Independent risk factors for epilepsy included cortical contact (OR 8.6, 95% CI 4.2–15.5, P<0.001) and a higher proliferation index (OR 5.7, 95% CI 1.3–26.2, P=0.02). Patients with PCNSL and epilepsy had a significantly shorter PFS (median 9.6 vs. 14.1 months, aHR 1.4, 95% CI 1.0–1.9, P=0.03), but no significant difference in OS (17 vs. 44.1 months, log-rank test, P=0.09).

They found that epilepsy impacted 25% of patients with PCNSL, often presenting at diagnosis and possibly indicating disease progression. Further research is needed to confirm the findings beyond a single-center study.

Source:  neurology.org/doi/10.1212/WNL.0000000000209748