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2HELPS2B score for seizure risk on cEEG
Seizure probability on continuous EEG in hospitalised patients.
2HELPS2B score for seizure risk on cEEG
Brief (potentially ictal) rhythmic discharges (BIRDs)
Lateralised periodic discharges, LRDA, or bilateral independent periodic discharges
Sporadic epileptiform discharges
Any periodic/rhythmic pattern with frequency >2.0 Hz
"Plus" features (superimposed fast or rhythmic activity)
Prior clinical seizure (before or during this admission)
Result0 points
Estimated seizure risk over the recorded period about 5 %. Brief screening EEG may be sufficient.
- Seizure risk
- 5 %
When to use
- Deciding how long to continue EEG monitoring in an acutely ill patient with an initial recording.
Formula
Points: BIRDs 2; LPDs/LRDA/BIPDs 1; sporadic epileptiform discharges 1; pattern frequency >2 Hz 1; plus features 1; prior seizure 1. Range 0-7.
Pearls and pitfalls
- A score of 0 carries roughly a 5% seizure risk; scores >=2 support extended monitoring.
- Findings are based on standardised critical-care EEG terminology.