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2HELPS2B Score

NeurologyEEGSeizure riskBeta toolThis tool is in beta. It has undergone internal validation but still requires additional testing. Always confirm the data entered and the results obtained before clinical use. It should not be used as the sole basis for clinical decisions.
Brief potentially ictal rhythmic discharges (BIRDs) presentUse a documented yes/no finding from formal EEG interpretation. Do not treat unknown findings as absent.
Lateralized periodic discharges, lateralized rhythmic delta activity, or bilateral independent periodic discharges presentRecord whether one of the scored periodic or rhythmic EEG patterns is explicitly present under standardized critical care EEG terminology.
Prior seizureRecord the prior-seizure item from the clinical history and formal EEG review.
Sporadic epileptiform discharges presentRecord an explicit yes/no finding from formal EEG interpretation.
Periodic or rhythmic pattern frequency >2.0 HzAnswer yes only when the scored rhythmic or periodic pattern exceeds 2.0 Hz.
Plus features presentUse ACNS-style EEG interpretation and record whether plus features are explicitly present.

Clinical noticeClinician-facing cEEG seizure-risk support only. Interpret with formal EEG review and local protocols.

Context and use

2HELPS2B = BIRDs (2) + lateralized/bilateral periodic or rhythmic pattern (1) + prior seizure (1) + sporadic epileptiform discharges (1) + frequency >2 Hz (1) + plus features (1)

Total 0-7 points. A score of 0 maps to 5% risk; 1 maps to 12%; scores >=2 map to higher risk and about 24 hours of cEEG.

Do not use for routine EEG, short-duration monitoring, or uncertain or undocumented EEG findings.

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