2HELPS2B Score

The 2HELPS2B Score was designed to stratify seizure risk in hospital inpatients, and thus improve cost-effectiveness of continuous EEG (cEEG). By doing an initial 1 hour-long EEG and applying the score, patients can be stratified to stop EEG monitoring at that point, or continue to 12 hour or 24-hour cEEG monitoring. To achieve at least a less than 5% risk of undetected seizures, a 2HELPS2B score of 0 only required the 1-hour screening EEG, a 2HELPS2B score of 1 required 12 hours, and a 2HELPS2B score of 2 or greater required 24 hours. The risks of seizures (within 72 hours) for each possible 2HELPS2B score are 5% for a score of 0, 12% for a score of 1, 27% for a score of 2, 50% for a score of 3, 73% for a score of 4, 88%for a score of 5, and greater than 95% for a score of 6 or 7. The score was created in 2017 (Struck et al, 2017), and validated in 2020. It does not apply to patients admitted for elective epilepsy monitoring and post-cardiac arrest patients.