2HELPS2B Score

Estimates the probability of an electrographic seizure within 72 hours in a hospitalized patient undergoing EEG/cEEG to guide how long to monitor — validated in adult inpatients with the EEG scored by a trained reader using ACNS Critical Care EEG Terminology; it predicts seizure risk to triage monitoring duration and does not replace continuous EEG or clinical judgment (not validated in neonates).

Any periodic or rhythmic pattern with frequency STRICTLY >2.0 Hz (a pattern at exactly 2.0 Hz does not count)

Sporadic (independent, nonperiodic/nonrhythmic) epileptiform discharges

LPDs OR LRDA OR BIPDs present (this trio counts once, not per pattern)

'Plus' features (superimposed rhythmic, sharp, or fast activity, e.g. LPD+F, GRDA+S)

Prior seizure (acute clinical/electrographic seizure this admission OR remote seizure history)

BIRDs present (brief potentially ictal rhythmic discharges) — the only +2 feature