Seizures in patents with primary central nervous system lymphoma: Prevalence and associated features

J Neurol Sci. 2019 May 15:400:34-38. doi: 10.1016/j.jns.2019.03.011. Epub 2019 Mar 14.

Abstract

Objective: Primary central nervous system (CNS) lymphoma (PCNSL) is a rare, aggressive, yet highly chemosensitive form of non-Hodgkin lymphoma which is associated with significant morbidity. Very little is known about the long-term risk for and features of seizures associated with this condition.

Methods: We performed a retrospective and longitudinal analysis of 36 patients with pathologically and radiographically confirmed primary CNS lymphoma to evaluate the incidence, prevalence and features associated with seizures. Demographic, radiographic, histological and electroencephalographic (EEG) data were included as part of the study.

Results: One-third of patients with primary CNS lymphoma had clinical seizures of which two-thirds occurred at time of initial presentation, while the remainder developed during a mean follow-up time of 1.49 years. The incidence rate of first seizure in PCNSL was 224.4 per 1000 persons, per year. There was a trend towards association with seizures in patients with cortical lesions relative to patients with subcortical lesions. EEG revealed epileptiform discharges in 44.4% of patients with both PCNSL and clinical seizures which suggests that it is a useful diagnostically in a substantial proportion of patients.

Conclusions: A significant percentage of patients with primary CNS lymphoma develop comorbid seizures during their disease course. Increased awareness and collaboration between neuro-oncologists and epileptologists may enhance and improve care for these patients.

Keywords: Complications; Epilepsy; Morbidity; PCNSL.

MeSH terms

  • Adult
  • Aged
  • Central Nervous System Neoplasms / diagnostic imaging*
  • Central Nervous System Neoplasms / epidemiology*
  • Central Nervous System Neoplasms / physiopathology
  • Cohort Studies
  • Electroencephalography / methods
  • Female
  • Follow-Up Studies
  • Humans
  • Longitudinal Studies
  • Lymphoma, Non-Hodgkin / diagnostic imaging*
  • Lymphoma, Non-Hodgkin / epidemiology*
  • Lymphoma, Non-Hodgkin / physiopathology
  • Male
  • Middle Aged
  • Prevalence
  • Retrospective Studies
  • Seizures / diagnostic imaging*
  • Seizures / epidemiology*
  • Seizures / physiopathology