Table: Modified Glasgow Coma Scale for Infants and Children-Merck Manual Professional Edition

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 decorticate posturing (abnormal flexion)	3
	Responds to pain with decerebrate posturing (abnormal extension)	Responds to pain with decerebrate posturing (abnormal extension)	2
	No response	No response	1
* Score ≤ 12 suggests a severe head injury. Score < 8 suggests the possible need for intubation and ventilation. Score ≤ 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, Tyler DC, Jones TK, et al: Coma scale for use in brain-injured children. Critical Care Medicine 12:1018–1020, 1984. doi: 10.1097/00003246-198412000-00002

Area Assessed

Infants

Children

Score*

Eye opening

Open spontaneously

Open in response to verbal stimuli

Open in response to pain only

No response

Verbal response

Coos and babbles

Oriented, appropriate

Irritable cries

Confused

Cries in response to pain

Inappropriate words

Moans in response to pain

Incomprehensible words or nonspecific sounds

No response

Motor response†

Moves spontaneously and purposefully

Obeys commands

Withdraws to touch

Localizes painful stimulus

Withdraws in response to pain

Responds to pain with decorticate posturing (abnormal flexion)

Responds to pain with decerebrate posturing (abnormal extension)

No response

* Score ≤ 12 suggests a severe head injury. Score < 8 suggests the possible need for intubation and ventilation. Score ≤ 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, Tyler DC, Jones TK, et al: Coma scale for use in brain-injured children. Critical Care Medicine 12:1018–1020, 1984. doi: 10.1097/00003246-198412000-00002