GCS (peds)

Eyes

4 Opens eyes spontaneously

3 Opens eyes to speech only

2 Opens eyes to pain only

1 Does not open eyes

Motor

6 Normal spontaneous movement

5 Withdraws to touch

4 Withdraws to pain¹

3 Abnormal flexion to pain² (Decorticate response)

2 Abnormal extension to pain² (Decerebrate response)

1 No response

Note:

1. For Motor score 4, pain is defined flat, fingernail pressure (often performed with the barrel of a pencil).
2. For Motor scores 2 and 3, pain is defined by pressing hard on the supraorbital notch. If this unsuccessful, sternal pressure may also be attempted.

Verbal

5 Smiles, coos, babbles

4 Irritable, crying (but consolable)

3 Persistent, inconsolable crying or crying only in response to pain

2 Moans in response to pain

1 No response

References

1. Holmes JF, Palchak MJ, MacFarlane T, et al. Performance of the pediatric glasgow coma scale in children with blunt head trauma. Acad Emerg Med. 2005 Sep;12(9):814-9.
2. James HE. Neurologic evaluation and support in the child with an acute brain insult. Pediatr Ann. 1986 Jan;15(1):16-22.
3. Kirkham FJ, Newton CR, Whitehouse W. Paediatric coma scales. Dev Med Child Neurol. 2008 Apr;50(4):267-74.