Modified Glasgow Coma Scale for Infants and Children

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Modified Glasgow Coma Scale for Infants and Children

Area Assessed	Infants	Children	Score*

Eye opening	Open spontaneously	Open spontaneously	4
	Open in response to verbal stimuli	Open in response to verbal stimuli	3
	Open in response to pain only	Open in response to pain only	2
	No response	No response	1


Verbal response	Coos and babbles	Oriented, appropriate	5
	Irritable cries	Confused	4
	Cries in response to pain	Inappropriate words	3
	Moans in response to pain	Incomprehensible words or nonspecific sounds	2
	No response	No response	1


Motor response**	Moves spontaneously and purposefully	Obeys commands	6
	Withdraws to touch	Localizes painful stimulus	5
	Withdraws in response to pain	Withdraws in response to pain	4
	Responds to pain with decorticate posturing (abnormal flexion)	Responds to pain with flexion	3
	Responds to pain with decerebrate posturing (abnormal extension)	Responds to pain with extension	2
	No response	No response	1

*Score:
12 suggests a severe head injury.
8 suggests need for intubation and ventilation.
6 suggests need for intracranial pressure monitoring.

**If the patient is intubated, unconscious, or preverbal, the most important part of this scale is motor response. This section should be carefully evaluated.

Adapted from Davis RJ et al: Head and spinal cord injury. In Textbook of Pediatric Intensive Care, edited by MC Rogers. Baltimore, Williams & Wilkins, 1987; James H, Anas N, Perkin RM: Brain Insults in Infants and Children. New York, Grune & Stratton, 1985; and Morray JP et al: Coma scale for use in brain-injured children. Critical Care Medicine 12:1018, 1984.

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