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Glasgow Coma Scale and Pediatric Glasgow Coma Scale

Sign	Glasgow Coma Scale^[1]	Pediatric Glasgow Coma Scale^[2]	Score
Eye opening	Spontaneous	Spontaneous	4
	To command	To sound	3
	To pain	To pain	2
	None	None	1
Verbal response	Oriented	Age-appropriate vocalization, smile, or orientation to sound; interacts (coos, babbles); follows objects	5
	Confused, disoriented	Cries, irritable	4
	Inappropriate words	Cries to pain	3
	Incomprehensible sounds	Moans to pain	2
	None	None	1
Motor response	Obeys commands	Spontaneous movements (obeys verbal command)	6
	Localizes pain	Withdraws to touch (localizes pain)	5
	Withdraws	Withdraws to pain	4
	Abnormal flexion to pain	Abnormal flexion to pain (decorticate posture)	3
	Abnormal extension to pain	Abnormal extension to pain (decerebrate posture)	2
	None	None	1
Best total score			15

The Glasgow Coma Scale (GCS) is scored between 3 and 15, with 3 being the worst and 15 the best. It is composed of 3 parameters: best eye response (E), best verbal response (V), and best motor response (M). The components of the GCS should be recorded individually; for example, E2V3M4 results in a GCS of 9. A score of 13 or higher correlates with mild brain injury, a score of 9 to 12 correlates with moderate injury, and a score of 8 or less represents severe brain injury. The Pediatric Glasgow Coma Scale (PGCS) was validated in children 2 years of age or younger.

Data from:

Teasdale G, Jennett B. Assessment of coma and impaired consciousness. A practical scale. Lancet 1974; 2:81.
Holmes JF, Palchak MJ, MacFarlane T, Kuppermann N. Performance of the pediatric Glasgow coma scale in children with blunt head trauma. Acad Emerg Med 2005; 12:814.

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