癫痫是脑肿瘤的常见合并症；然而，对于原发性中枢神经系统淋巴瘤（PCNSL）癫痫发作的患病率、发病时间、症状学和危险因素知之甚少。我们的目标是确定 PCNSL 中癫痫的患病率，确定与癫痫相关的因素，并研究 PCNSL 中癫痫发作的预后意义。我们在三级神经肿瘤中心进行了一项观察性、回顾性单中心研究（2011- 2023）包括免疫功能正常的 PCNSL 患者且无癫痫病史。我们收集临床、影像和治疗数据； PCNSL 过程中的癫痫发作状态；以及肿瘤学和癫痫结果。主要结果是确定癫痫的患病率。此外，我们的目的是确定与癫痫相关的临床、放射学和治疗相关因素。对分类变量使用 χ2 检验，对连续变量使用非配对 t 检验进行单变量分析。未经调整的分析中确定的预测因子包含在向后逐步逻辑回归模型中。我们纳入了 330 名患者，其中 157 名 (47.6%) 为男性，诊断时的中位年龄为 68 岁，中位卡诺夫斯基表现状态评分为 60。 83 ( 25.2%）患者从初次诊断到最后一次随访至少有 1 次癫痫发作，其中 40 例（12.1%）为发病症状，16 例（4.8%）在一线治疗期间，27 例（8.2%）在肿瘤进展时发生，6 例在肿瘤进展时发生。 (1.8%) 缓解期间。局灶性癫痫发作是最常见的癫痫发作类型，有 43 名患者（51.8%）发生。 97.6% 的患者在抗癫痫药物治疗下癫痫发作消失。皮质接触（比值比 [OR] 8.6，95% CI 4.2-15.5，p < 0.001）和较高的增殖指数（OR 5.7，95% CI 1.3-26.2，p = 0.02）被确定为癫痫的独立危险因素。 PCNSL 合并癫痫患者的无进展生存期显着缩短（中位无进展生存期 9.6 个月 vs 14.1 个月，调整后风险比 1.4，95% CI 1.0-1.9，p = 0.03），但总生存期并未显着缩短（17 vs 44.1 个月，对数秩检验，p = 0.09）。四分之一的 PCNSL 患者患有癫痫，其中一半在初次就诊时经历过癫痫，并可能作为疾病进展的标志。有必要进行进一步的研究来评估这些发现的更广泛的适用性，因为它们受到回顾性设计和三级中心设置的限制。

Epilepsy is a common comorbidity of brain tumors; however, little is known about the prevalence, onset time, semiology, and risk factors of seizures in primary CNS lymphoma (PCNSL). Our objectives were to determine the prevalence of epilepsy in PCNSL, to identify factors associated with epilepsy, and to investigate the prognostic significance of seizures in PCNSL.We performed an observational, retrospective single-center study at a tertiary neuro-oncology center (2011-2023) including immunocompetent patients with PCNSL and no history of seizures. We collected clinical, imaging, and treatment data; seizure status over the course of PCNSL; and oncological and seizure outcome. The primary outcome was to determine the prevalence of epilepsy. Furthermore, we aimed to identify clinical, radiologic, and treatment-related factors associated with epilepsy. Univariate analyses were conducted using the χ2 test for categorical variables and unpaired t test for continuous variables. Predictors identified in the unadjusted analysis were included in backward stepwise logistic regression models.We included 330 patients, 157 (47.6%) were male, median age at diagnosis was 68 years, and the median Karnofsky Performance Status score was 60. Eighty-three (25.2%) patients had at least 1 seizure from initial diagnosis to the last follow-up, 40 (12.1%) as the onset symptom, 16 (4.8%) during first line of treatment, 27 (8.2%) at tumor progression and 6 (1.8%) while in remission. Focal aware seizures were the most frequent seizure type, occurring in 43 (51.8%) patients. Seizure freedom under antiseizure medication was observed in 97.6% patients. Cortical contact (odds ratio [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) were identified as independent risk factors of epilepsy. Patients with PCNSL and epilepsy had a significantly shorter progression-free survival (median progression-free survival 9.6 vs 14.1 months, adjusted hazard ratio 1.4, 95% CI 1.0-1.9, p = 0.03), but not a significantly shorter overall survival (17 vs 44.1 months, log-rank test, p = 0.09).Epilepsy affects a quarter of patients with PCNSL, with half experiencing it at the time of initial presentation and potentially serving as a marker of disease progression. Further research is necessary to assess the broader applicability of these findings because they are subject to the constraints of a retrospective design and tertiary center setting.