---
title: Pediatric Glasgow Coma Scale
authors:
    - Sam Ashoo, MD
created: 2018/07/03
updates:
categories:
    - Trauma
    - Pediatrics
---

# Pediatric Glasgow Coma Scale

Also see the card on [Pediatric Blunt Head Trauma (PECARN Study)](/cards/pediatric-head-injury).

This variation of the adult Glasgow Coma Scale (GCS) is for children age <2 years old

- Total = 15 points 
- GCS score most useful when stated as individual sub-scores and total:  E4/V5/M6 = 15
- Should be applied in the assessment of children ≤2 years old in the PECARN Pediatric Head Injury decision tool [1](#ref_one)

# Head Injury Classification

| **Glasgow Coma Scale Score** | **Head Injury Severity** |
| ---------------------------- | ------------------------ |
| ≥13                          | Minor head injury        |
| 9-12                         | Moderate head injury     |
| ≤8                           | Severe head injury       |

# Eyes

| **Points** | **Behavior**           |
| ---------- | ---------------------- |
| 4          | Open spontaneously     |
| 3          | Open to verbal stimuli |
| 2          | Open to pain only      |
| 1          | No response            |

# Verbal

| **Points** | **Behavior**              |
| ---------- | ------------------------- |
| 5          | Coos, babbles             |
| 4          | Irritably cries           |
| 3          | Cries in response to pain |
| 2          | Moans in response to pain |
| 1          | No response               |

# Motor

| Points |                                                    |
| ------ | -------------------------------------------------- |
| 6      | Moves spontaneously / purposefully                 |
| 5      | Withdraws to touch                                 |
| 4      | Withdraws to pain                                  |
| 3      | Flexor posturing to pain (decorticate posturing)   |
| 2      | Extensor posturing to pain (decerebrate posturing) |
| 1      | No response                                        |

## References

1. <a id="ref_one"></a>Borgialli DA, Mahajan P, Hoyle JD, et al. Performance of the Pediatric Glasgow Coma Scale Score in the Evaluation of Children With Blunt Head Trauma. Acad Emerg Med. 2016;23(8):878-84. (Validation study) [PubMed](https://www.ncbi.nlm.nih.gov/pubmed/27197686)
2. Teasdale G, Jennett B. Assessment of coma and impaired consciousness. A practical scale. Lancet. 1974;2(7872):81-4. (Original development) [PubMed](https://www.ncbi.nlm.nih.gov/pubmed/4136544)
3. James HE. Neurologic evaluation and support in the child with an acute brain insult. Pediatr Ann. 1986;15(1):16-22. (Original development) [PubMed](https://www.ncbi.nlm.nih.gov/pubmed/3951884)
