Glasgow Coma Scale - Pediatric 

Updated: Dec 05, 2014
  • Author: Buck Christensen; Chief Editor: Buck Christensen  more...
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Pediatric Glasgow Coma Scale

The Glasgow Coma Scale (GCS) is used to describe the general level of consciousness in patients with traumatic brain injury (TBI) and to define broad categories of head injury. [1] The GCS is divided into 3 categories, eye opening (E), motor response (M), and verbal response (V). The score is determined by the sum of the score in each of the 3 categories, with a maximum score of 15 and a minimum score of 3, as follows:

GCS score = E + M + V

Also see Medscape’s Glasgow Coma Scale Calculator.

Table 1. Glasgow Coma Scale (Open Table in a new window)

Eye Opening

Score

Age 1 Year or Older

Age 0-1 Year

4

Spontaneously

Spontaneously

3

To verbal command

To shout

2

To pain

To pain

1

No response

No response

Best Motor Response

Score

Age 1 Year or Older

Age 0-1 Year

6

Obeys command

 

5

Localizes pain

Localizes pain

4

Flexion withdrawal

Flexion withdrawal

3

Flexion abnormal (decorticate)

Flexion abnormal (decorticate)

2

Extension (decerebrate)

Extension (decerebrate)

1

No response

No response

Best Verbal Response

Score

Age >5 Years

Age 2-5 Years

Age 0-2 Years

5

Oriented and converses

Appropriate words

Cries appropriately

4

Disoriented and converses

Inappropriate words

Cries

3

Inappropriate words; cries

Screams

Inappropriate crying/screaming

2

Incomprehensible sounds

Grunts

Grunts

1

No response

No response

No response

Interpretation

Patients who are intubated are unable to speak, and their verbal score cannot be assessed. They are evaluated only based on eye opening and motor scores, and the suffix T is added to their score to indicate intubation. In intubated patients, the maximum GCS score is 10T and the minimum score is 2T. The GCS is often used to help define the severity of TBI. Mild head injuries are generally defined as those associated with a GCS score of 13-15, and moderate head injuries are those associated with a GCS score of 9-12. A GCS score of 8 or less defines a severe head injury. These definitions are not rigid and should be considered as a general guide to the level of injury.