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Glasgow Coma Scale
and the Causes of Coma

The Glasgow Coma Scale (GCS) is used to assess consciousness levels. The minimum score is 3 (deep unconsciousness), the maximum is 15 (full consciousness).

Test Type 
SCORE
1
2 3 4
5
6
Eye
Closed
Open to pain Open to voice Open spontaneously
-
 
Motor Response
No movement
Displays extension Displays flexion Displays withdrawal from pain
Localises pain
Voluntary
Vocal Response
None
Groans Inappropriate words Disorientated speech
Orientated speech
 
Causes of Coma
Cerebral
· Intracranial haemorrhage
· Large cerebral infarct
· Pontine haemorrhage (pinpoint pupils)
· Cerebral venous sinus thrombosis
· Hypertensive encephalopathy
· Cerebral tumour
· Head injury
· Cerebral infection—encephalitis, meningitis, cerebral malaria, brain abscess
· Post-ictal state
· Sub-clinical status epilepticus
· Cerebral vasculitis
· End-stage multiple sclerosis
· Leucodystrophy
· Creutzfeldt-Jakob disease
Metabolic  · Drugs
· Alcohol excess
· Hypoglycaemia
· Diabetic ketoacidosis
· Hyperosmolar non-ketotic coma
· Uraemia
· Late stages of hepatic encephalopathy
· Severe hyponatraemia
· Hypothyroidism
· Hypercalcaemia
· Inborn error of metabolism
· Type 2 respiratory failure
· Severe hypothermia
· Hyperpyrexia
· Severe nutritional deficiency


Sources

Provan, D. and A. Krentz. Oxford Handbook of Clinical and Laboratory Investigation. Oxford, etc.: Oxford University Press, 2002.

 

 

 

 

 

 

 

 




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