What is the Clinical Assessment of Value of Epilepsy (CAVE) score in seizures?

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Last updated: May 23, 2025 • View editorial policy

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From the Guidelines

The CAVE score is used to estimate the risk of late seizures (>7 days after ICH) and can be a useful tool in guiding clinical decision-making. The CAVE score is a risk assessment tool that can be used to predict the likelihood of late seizures in patients with intracerebral hemorrhage (ICH) 1.

Key Components of the CAVE Score

  • The CAVE score takes into account several factors to estimate the risk of late seizures, although the specific components of the score are not detailed in the provided evidence 1.
  • The score is mentioned as a potential tool for estimating the risk of late seizures, but its exact composition and calculation are not specified in the study 1.

Clinical Application of the CAVE Score

  • The CAVE score can be used to inform clinical decisions about the management of patients with ICH, particularly in terms of seizure risk 1.
  • However, it is noted that the score should not be used to guide the continuation of antiepileptic drugs in the absence of evidence that these medications prevent late seizures after ICH 1.

Limitations and Considerations

  • The evidence surrounding the use of the CAVE score and antiepileptic medications in patients with ICH is limited, and more research is needed to fully understand their effectiveness 1.
  • Clinicians should exercise caution when interpreting the CAVE score and consider it as one part of a comprehensive assessment of seizure risk in patients with ICH 1.

From the Research

Definition of CAVE Score

  • The CAVE score is a prognostic score used to estimate the risk of late seizures in patients with intracerebral hemorrhage (ICH) 2.
  • The score ranges from 0 to 4 points, with 1 point for each of the following factors: cortical involvement, age < 65 years, volume > 10 mL, and early seizures within 7 days of ICH 2.

Calculation of CAVE Score

  • The CAVE score is calculated by assigning 1 point for each of the above-mentioned factors, resulting in a total score ranging from 0 to 4 2.
  • A higher CAVE score indicates a higher risk of late seizures, with scores of 0,1,2,3, and 4 corresponding to risks of 0.6%, 3.6%, 9.8%, 34.8%, and 46.2%, respectively 2.

Validation of CAVE Score

  • The CAVE score has been validated in several studies, including a retrospective analysis of the Helsinki ICH Study and the Lille Prognosis of InTra-Cerebral Hemorrhage cohort 2.
  • The score has also been compared to other prediction scores, such as the CAVS and LANE scores, and has been found to have similar accuracy in predicting late seizures 3.
  • A modified version of the CAVE score, known as the CAVE2 score, has also been developed and validated, which assigns 2 points for cortical involvement instead of 1 point 4.

Clinical Application of CAVE Score

  • The CAVE score can be used to identify patients with ICH who are at high risk of late seizures and may benefit from anticonvulsant therapy 2, 4.
  • The score can also be used to inform clinical decision-making and guide the management of patients with ICH 3.

References

1
Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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