Antiepileptic drugs failed to prevent initial seizures or improve survival outcomes in patients with primary CNS lymphoma

Abstract This study examined the prevalence, risk factors, and prognosis of epilepsy in patients with primary central nervous system lymphoma (PCNSL) and explored the necessity of prophylactic antiepileptic treatment in this population. In this retrospective, observational, single-center study, we a...

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Main Authors: Mengxue Zhang, Yunan Ling, Yanwei Zeng, Jingjing Ma, Zhiguang Lin, Qing Li, Hui Kang, Bobin Chen, Yan Ma
Format: Article
Language:English
Published: Nature Portfolio 2025-03-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-94477-1
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Summary:Abstract This study examined the prevalence, risk factors, and prognosis of epilepsy in patients with primary central nervous system lymphoma (PCNSL) and explored the necessity of prophylactic antiepileptic treatment in this population. In this retrospective, observational, single-center study, we analyzed clinical data from PCNSL patients who were diagnosed at our institution between January 2018 and April 2023. The cohort comprised 214 patients with PCNSL (with a median age of 62 years), of which 128 (47.6%) patients were male. Epilepsy was observed in 16.82% (36/214) of the patients, with 9.35% (20/214) presenting with seizures as the initial symptom. Cortical involvement was significantly associated with seizures (OR = 9.512, 95% CI 3.870–23.381; p = 0.036). Other potential risk factors included an edema zone > 1 cm around the lesion and PIM1 wild-type status. Antiepileptic drugs (AEDs) neither reduced seizure incidence (8.11% with AEDs vs. 8.43% with no AEDs, p = 0.970) nor improved PFS (HR = 0.613, 95% CI 0.338–1.109; p = 0.106). Therefore, AEDs should not be used as preventive measures in this population.
ISSN:2045-2322