Glasgow Coma Scale (GCS)

Classification of Brain injury severity

Authors

Affiliations

Nate Yomogida, PT, DPT

Doctor of Physical Therapy

B.S. in Kinesiology

Chloë Kerstein, PT, DPT

Doctor of Physical Therapy

B.A. in Neuroscience

Table 1: Glasgow Coma Scale

Component	Score	Response	Description
Eye Opening (E)	4	Spontaneous	Eyes open without stimulation.
	3	To Speech	Eyes open in response to verbal stimuli.
	2	To Pain	Eyes open in response to painful stimuli (e.g., pinch).
	1	No response	No eye opening at all
Verbal Response (V)	5	Oriented	Patient is aware of surroundings and can respond appropriately.
	4	Confused	Patient can speak but is disoriented and confused about time, place, or person.
	3	Inappropriate Words	Patient utters words not appropriate to the context.
	2	Incomprehensible Sounds	Patient makes sounds that are not recognizable as words (e.g., moaning).
	1	No response	No verbal response at all.
Motor Response (M)	6	Obeys Commands	Patient can follow simple commands.
	5	Localizes Pain	Patient can purposefully move toward painful stimuli.
	4	Withdraws from Pain	Patient withdraws from painful stimuli.
	3	Flexion to Pain	Abnormal flexion in response to pain (Decorticate Posturing).
	2	Extension to Pain	Abnormal extension in response to pain (Decerebrate Posturing).
	1	None	No motor response at all.

Interpretation

\[ \textrm{GCS Score} = \textrm{Eye} + \textrm{Verbal} + \textrm{Motor} \]

• Range: 3-15

GCS Interpretation¹

Score	Brain damage severity
13-15	Mild
9-12	Moderate
≤8	Severe

References

1.

Fulk GD, Chui KK, eds. O’Sullivan and Schmitz’s Physical Rehabilitation. 8th ed. F. A. Davis Company; 2024.