Prognostic Score of Brosset et al for Neonatal Seizures

Brosset et al developed a prognostic score for neonates having seizures. The score was developed at the Hopital Universitaire Dupuytren, Limoges.

NOTE: This is my translation from the French. Please verify before use.

Parameters used in the score:

(1) EEG

(2) neurological examination

(3) etiology for seizure

(4) type of seizure

(5) birthweight for the infant

Parameter	Finding	Points
EEG	normal (Class I)	0
	moderately abnormal (Class II or III)	1
	very abnormal (Class IV or V)	2
neurologic examination	normal	0
	minimal abnormalities (moderate hypotonia, hyperexcitability, etc.)	1
	very abnormal (severe hypotonia, marked hypertonia, asymmetry in tone or reflexes)	2
etiology for the seizures	unknown, late hypocalcemia, electrolyte abnormalities	0
	early hypocalcemia, hypoglycemia, subarachnoid hemorrhage, intraventricular hemorrhage Grade I or II, Stage II hypoxic-ischemic encephalopathy	1
	meningitis, cerebral malformation, stage III hypoxic-ischemic encephalopathy, intraventricular hemorrhage Grade III or IV	2
type of seizure	atypical	0
	clonic focal or multifocal	1
	tonic or myoclonic	2
birthweight	>= 1,500 grams	0
	< 1,500 grams	2

prognostic score =

= SUM(points for the 5 parameters)

Interpretation:

• minimum score: 0

• maximum score: 10

Score	Prognosis	Need for Prolonged Anticonvulsant Therapy (Continue after Discharge)
<= 5	favorable	no
>= 6	at risk	often yes

from page 374

from page 373

Limitations:

• The score was developed in 1984 and prognosis will have been affected by improved diagnostic techniques and treatments.

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