Immune Effector Cell Associated Neurotoxicity Syndrome Grade 4

**Semantic type:** Disease or Syndrome

**Definition:** Immune effector cell-associated neurotoxicity syndrome (ICANS) characterized by an immune-effector cell-associated encephalopathy (ICE) tool score of 0 or if the ICE scale cannot be performed (for adults and children over 12), or if the Cornell Assessment of Pediatric Delirium (CAPD) scale cannot be performed (for children 12 and under), the inability of the affected individual to be arousable without vigorous or repetitive tactile stimuli, life-threatening prolonged (greater than 5 minutes) seizures, or repetitive clinical or electroencephalographically-detected seizures without ever returning to baseline, deep focal motor weakness, diffuse cerebral edema evident on neuroimaging, decerebrate or decorticate posturing, cranial nerve VI palsy, papilledema or Cushing's triad (bradycardia, hypertension, respiratory depression).

**Synonyms:** - ICANS Grade 4 - ICANS Grade 4