Glasgow Coma Scale

There are different levels of coma, ranging from very deep, where the patient shows no response or awareness at all, to shallower levels, where the patient responds to stimulation by movement or opening eyes. Still shallower levels can occur, where the patient is able to make some response to speech. Level of coma is usually initially assessed by the Glasgow Coma Scale (GCS).

The GCS is a very simple, easy to administer technique which is used to rate the severity of coma. It assesses the patient’s ability to open their eyes, move and speak. The total score is calculated by adding up the scores from the different categories, shown in the tables below, and ranges from a minimum of 3 to a maximum of 15.

Best motor response
6 Obeying commands 
Movement localised to stimulus 
Abnormal muscle bending and flexing 
Involuntary muscle straightening and extending 
Verbal responses
5 Orientated response
Confused conversation
Inappropriate words
Incomprehensible sounds
Eye opening
4 Spontaneous
To speech
To pain

The degree and duration of a coma are helpful indicators of the severity of a brain injury, and taken in conjunction with the length of time a person is experiencing post-traumatic amnesia, can indicate the likely prognosis for an individual.