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Estimation of awareness impairment using the consciousness seizure scale (CSS)

NY Nada El Youssef
AJ Aude Jegou
JM Julia Makhalova
LN Lionel Naccache
CB Christian Bénar
FB Fabrice Bartolomei
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We analyzed the alteration of awareness using the Consciousness Seizure Scale, CSS14. The scoring was done by two neurologists (NEY and FB) and the mean of the two scores was taken. The CSS relies on an eight-criterion scale taking into account the different components of consciousness: (1) unresponsiveness, (2) visual attention, (3) interaction, (4) consciousness of the seizure, (5) adapted behavior, (6) post-ictal amnesia and (7) interictal amnesia. Finally, the (8) “global appreciation criterion” based on the physician global assessment and scored between 0 and 2. The timing of the maximal alteration of consciousness (as determined by the scorer) was set as Tmax.

According to our previous studies14,15,45, the seizures were classified into Group A (score 0 to 1), Group B (score 2 to 5) and Group C (score 6 to 9) with Group A corresponding to preserved awareness, Group B to intermediate alteration of awareness and Group C to profound alteration of awareness.

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