The Immune Effector Cell Encephalopathy (ICE) score is a 10-point bedside neurologic screening tool used to assess neurocognitive function in patients receiving immune effector cell therapies, especially CAR T-cell therapy. It is part of the ASTCT framework for evaluating ICANS (immune effector cell–associated neurotoxicity syndrome).

It measures 5 areas:

• Orientation to year, month, city, and hospital = 4 points
• Naming 3 objects = 3 points
• Following commands = 1 point
• Writing a standard sentence = 1 point
• Attention by counting backward from 100 by tens = 1 point

The total score runs from 0 to 10, and lower scores mean worse encephalopathy. In common clinical use:

• 10 = normal
• 7–9 = mild impairment
• 3–6 = moderate impairment
• 0–2 = severe impairment

One important detail: the ICE score is not the same thing as the full ICANS grade. Full ICANS grading also considers level of consciousness, seizures, motor findings, and evidence of raised intracranial pressure/cerebral edema. For example, an ICE score of 0 can correspond to different ICANS grades depending on whether the patient is awake or unarousable.

So in plain language, the ICE score is a quick structured way to check how much CAR T-related neurocognitive dysfunction a patient has at the bedside.