Table 3.

ASTCT ICANS Consensus Grading for Adults¹⁹

Neurotoxicity domain	Grade 1	Grade 2	Grade 3	Grade 4
ICE score	7-9	3-6	0-2	0 (patient is unarousable or unable to perform ICE scale)
Level of consciousness	Awakens spontaneously	Awakens to voice	Awakens only to tactile stimulus	Patient is unarousable or requires vigorous or repetitive tactile stimuli to arouse. Stupor or coma
Seizure	N/A	N/A	Any clinical seizure focal or generalized that resolves rapidly or nonconvulsive seizures on EEG that resolve with intervention	Life-threatening prolonged seizure (>5 min); repetitive clinical or electrical seizures without return to baseline in between
Motor findings	N/A	N/A	N/A	Deep focal motor weakness such as hemiparesis or paraparesis
Elevated ICP/cerebral edema	N/A	N/A	Focal/local edema on neuroimaging	Diffuse cerebral edema on neuroimaging; decerebrate or decorticate posturing; cranial nerve VI palsy; papilledema; or Cushing’s triad