GCS and MRC scales
Quick reference for Glasgow Coma Scale and Medical Research Council scale scoring.
Glasgow Coma Scale (GCS)
The Glasgow Coma Scale is a standardized tool used to assess the level of consciousness in patients with traumatic brain injury or other acute neurological conditions. The GCS has three components: Eye Opening, Verbal Response, and Motor Response. Each is scored on a defined scale, and the three scores are added to give a total GCS score (minimum 3, maximum 15).
GCS Scoring Table
| Component | Score | Description |
|---|---|---|
| Eye Opening | 4 | Opens spontaneously |
| 3 | Opens to verbal command | |
| 2 | Opens to pain | |
| 1 | No response | |
| Verbal Response | 5 | Oriented (person, place, time) |
| 4 | Confused | |
| 3 | Inappropriate words | |
| 2 | Incomprehensible sounds | |
| 1 | No response | |
| Motor Response | 6 | Obeys commands |
| 5 | Localizes pain | |
| 4 | Withdraws from pain | |
| 3 | Abnormal flexion (decorticate) | |
| 2 | Abnormal extension (decerebrate) | |
| 1 | No response |
Interpretation:
- 13–15: Mild injury
- 9–12: Moderate injury
- 3–8: Severe injury
Medical Research Council (MRC) Scale
The Medical Research Council Scale is a 0–5 scale used to grade muscle strength. It is widely used in neurology and neurosurgery to document the strength of specific muscles or limbs, especially after stroke, spinal cord injury, or nerve damage.
MRC Strength Scale
| Grade | Score | Description |
|---|---|---|
| 0 | 0 | No muscle contraction (complete paralysis) |
| 1 | 1 | Muscle twitch with no movement (visible or palpable) |
| 2 | 2 | Movement possible with gravity eliminated (e.g., sliding across table) |
| 3 | 3 | Movement against gravity, but no resistance |
| 4 | 4 | Movement against gravity and some resistance (weak) |
| 5 | 5 | Normal strength (full movement against gravity and resistance) |
Common notation:
Strength is often recorded as a fraction, e.g., 4/5 means the patient can move the limb against gravity and some resistance, but not normal strength. A 3/5 means the patient can move against gravity but cannot overcome any added resistance.
Using these scales in Usystems
In the neurosurgery case template, you enter GCS and MRC scores in the clinical assessment section. The scores are stored as part of the case record and can be referenced for follow-up visits, progress tracking, and clinical decision-making. When the case is invoiced, these objective clinical measures are included in the billing documentation.
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