Sheldon et al developed a simple score for determining if a patient is experiencing a seizure or syncopal episode. The authors are from the University of Calgary, McMaster University, and the Wales Heart Research Institute (Cardiff, Wales).
Parameter
Finding
Points
waking with tongue cut
no
0
yes
2
abnormal behavior observed by others (unusual posturing, witnessed unresponsivenss, limb jerking, other)
1
loss of consciousness during emotional stress
postictal confusion
head turning to one side during loss of consciousness
prodromal déjà vu (feeling something is very familiar) or jamais vu (feeling something is very unfamiliar)
any presyncope
-2
diaphoresis before a spell
loss of consciousness occurs after prolonged sitting or standing
total score =
= SUM(points for all 9 parameters)
Interpretation:
• minimum score: -6
• maximum score: 7
• A score >= 1 indicates a seizure disorder.
Performance:
• The authors claimed a sensitivity of 94% and specificity of 94%.
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Purpose: To use the score of Sheldon et al to determine if a patient has experienced a seizure or syncopal episode.
Specialty: Neurology
Objective: differential diagnosis and mimics, red flags
ICD-10: G40,
