FOUR Score


While the Glasgow Coma Scale (GCS) has been widely adopted to grade coma, it is limited by its inabillity to assess the verbal score in intubated patients and test brainstem reflexes. The FOUR (Full Outline of UnResponsiveness) score has some advantages to the GCS scale as it provides greater neurological detail and can recognize a locked-in syndrome as well as different stages of brain herniation. The FOUR score may also provide additional prognostic information in patients with low scores.

The FOUR score consists of four components (eye, motor, brainstem, and respiration), with a maximum score of 4 for each item.


Wijdicks EF et al.

Annals of Neurology 2005, 58 (4): 585-93

The FOUR Score calculator is created by QxMD.

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1. Eye Response?

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