The National Hospital Seizure Severity Scale (NHS3, where the S3 indicates Seizure Severity Scale) can be used to determine the severity of the seizures that a patient experiences. It can be used to evaluate anti-epileptic agents during clinical trials. The scale was developed at the Chalfont Centre for Epilepsy based on the Chalfont Seizure Severity Scale.
For each type of seizure that the person experiences (up to 3), the following is recorded, based on occurrence since the last visit.
Parameters:
(1) generalized convulsion
(2) fall to the ground (including falling out of bed)
(3) injury
(4) incontinent of feces and/or urine
(5) loss of consciousness with warning
(6) time to return to normal function
(7) automatism
|
Parameter |
Finding during this Type of Seizure |
Points |
|
generalized convulsion |
present |
4 |
|
|
absent |
0 |
|
fall |
never |
0 |
|
|
occasionally |
2 |
|
|
often |
3 |
|
|
nearly always |
4 |
|
|
always |
4 |
|
injury |
none |
0 |
|
|
mild injury or mild headache |
2 |
|
|
bitten tongue or severe headache |
3 |
|
|
burn, scald. deep cut, fracture |
4 |
|
incontinence |
never |
0 |
|
|
occasionally |
2 |
|
|
often |
3 |
|
|
nearly always |
4 |
|
|
always |
4 |
|
loss of consciousness |
with no warning |
2 |
|
|
sometimes with warning |
1 |
|
|
almost always with warning |
0 |
|
|
always with warning |
0 |
|
|
no loss of consciousness |
0 |
|
|
seizure only during sleep |
0 |
|
time to recover |
< 1 minute |
0 |
|
|
1 – 10 minutes |
1 |
|
|
11 – 60 minutes |
2 |
|
|
1 – 3 hours |
3 |
|
|
> 3 hours |
4 |
|
automatisms |
none |
0 |
|
|
mild or focal jerking |
2 |
|
|
seriously disruptive |
4 |
where:
• Occasional if occurred but < 25% of time.
• Often if occurs 25-50% of the time.
• If only 1 seizure occurred and event occurred during that seizure, nearly always or always should be used.
• Injuries are scored based on the most severe injury.
NHS3 score =
= SUM(points for all of the parameters) + 1
Interpretation:
• minimum score: 1
• maximum score: 27
• The higher the score, the more severe the seizure.
Purpose: To evaluate a patient with seizures using the National Hospital Seizure Severity Scale (NHS3).
Specialty: Neurology
Objective: severity, prognosis, stage
ICD-10: G40,
