GLASGOW COMA
SCALE
THIRD YEAR- PHYSIOTHERAPY IN NEUROLOGICAL CONDITIONS
CONTENT
1. INTRODUCTION
2. COMPONENTS OF GCS
3. SCORING- EYE
4. SCORING- VERBAL
5. SCORING- MOTOR
6. TOTAL GCS SCORE
7. CASE EXAMPLE
8. APPLICATION AND LIMITATION
9. MODIFIED GCS FOR CHILDREN
10. REFRENCES
INTRODUCTION
A Tool for Assessing Consciousness
Developed in 1974 by Graham Teasdale and Bryan Jennett.
Measures levels of consciousness in patients with head injury or
other conditions affecting brain function.
Used in emergency, ICU, and neurology settings.
COMPONENTS OF GCS
GCS evaluates three main responses:
1.Eye Opening (E): Scores 1–4
2.Verbal Response (V): Scores 1–5
3.Motor Response (M): Scores 1–6
SCORING BREAKDOWN
Eye Opening:
4 = Spontaneous
3 = To speech (hello, open your eyes)
2 = To pain (trapezius squeeze, supraorbital pressure)
1 = None
SCORING BREAKDOWN
Verbal Response:
5 = Oriented (knows place ,e.g. general hospital and time, e.g. day,
month and year)
4 = Confused (talking in sentences but disoriented in time and place)
3 = Inappropriate words (utters occasional words rather than sentences)
2 = Incomprehensible sounds
1 = None
SCORING BREAKDOWN
Motor Response:
6 = Obeys commands (grip my finger, make a fist)
5 = Localizes pain (trapezius squeeze, supraorbital pressure)
4 = Withdraws from pain (flexion of limbs)
3 = Flexion to pain (flexion, adduction and internal rotation of upper libs to pain -decorticate)
2 = Extension to pain (extension of upper and lower limbs - decerebrate)
1 = None
TOTAL GCS SCORE
Total Score Range: 3–15
•Severe: 3–8
•Moderate: 9–12
•Mild: 13–15
Lower scores indicate more severe brain dysfunction.
CASE EXAMPLE
1. A patient opens eyes to speech
2. Uses inappropriate words
3. Withdraws from pain
•Score: E3 + V3 + M4 = 10
•Interpretation: Moderate
APPLICATIONS AND LIMITATIONS
• Applications:
1. Monitoring traumatic brain injury (TBI).
2. Predicting patient outcomes.
• Limitations:
1. Cannot assess intubated patients without modifications.
2. Influence of drugs, alcohol, or metabolic disorders.
MODIFIED GCS FOR CHILDREN
• Adapted for children due to developmental differences.
• Uses age-appropriate verbal and motor response assessments
REFRENCES
1. NEUROLOGY AND NEUROSURGERY ILLUSTRATED
- KENNETH W LINDSAY (5th edition)
2. Sternbach GL. The Glasgow coma scale. The Journal of
emergency medicine. 2000 Jul 1;19(1):67-71.
THANK YOU
