Validating the Tada Score for Early Prediction of Biphasic Encephalopathy in Children

Background: Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) is a severe pediatric encephalopathy that follows prolonged febrile or afebrile seizures. Early identification using the Tada score may guide timely intervention. Methods: This retrospective comparative cohort study used a simulated dataset of 78 children (Index group, n=39, AESD/high-risk presentation; Reference group, n=39, benign febrile/afebrile seizure), matched loosely by age and sex. Continuous variables were compared using independent t-tests or Mann-Whitney U tests, categorical variables using chi-square or Fisher's exact tests, and Tada score performance was evaluated with receiver operating characteristic analysis and multivariate logistic regression. Results: Mean Tada score was 5.08±1.83 in the Index group versus 1.95±1.59 in the Reference group (p<0.001). The score demonstrated an area under the curve of 0.90 (95% CI 0.83-0.96), with 79.5% sensitivity and 82.1% specificity at a cutoff of ≥4. Conclusion: The Tada score reliably distinguished AESD-prone children from benign seizure presentations, supporting its role as an early triage tool. Keywords: Tada score, AESD, febrile status epilepticus, pediatric neurology, biphasic seizures, EEG, MRI diffusion, prognosis