Patient selection: critically ill patient
EEG monitoring: >= 6 hours
Parameters:
(1) brief ictal rhythmic discharges (BIRDS)
(2) lateralized periodic discharges, lateralized rhythmic delta activity or bilateral independent periodic discharges
(3) history of prior seizure
(4) sporadic epileptiform discharges
(5) frequency greater than 2.0 Hz for any periodic or rhythmic pattern
(6) presence of "plus" features (superimposed, rhythmic, sharp or fast activity)
|
Parameter
|
Finding
|
Points
|
|
brief ictal rhythmic discharges (BIRDS)
|
no
|
0
|
|
|
yes
|
2
|
|
lateralized periodic discharges, lateralized rhythmic delta activity or bilateral independent periodic discharges
|
no
|
0
|
|
|
yes
|
1
|
|
history of prior seizure
|
no
|
0
|
|
|
yes
|
1
|
|
sporadic epileptiform discharges
|
no
|
0
|
|
|
yes
|
1
|
|
frequency greater than 2.0 Hz for any periodic or rhythmic pattern
|
no
|
0
|
|
|
yes
|
1
|
|
presence of "plus" features (superimposed, rhythmic, sharp or fast activity)
|
no
|
0
|
|
|
yes
|
1
|
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 7
|
Total Score
|
Seizure Risk
|
|
0
|
< 5%
|
|
1
|
12%
|
|
2
|
27%
|
|
3
|
50%
|
|
4
|
73%
|
|
5
|
88%
|
|
6 or 7
|
95%
|
Performance:
• The area under the ROC curve is 0.82.
