glasgow_liege_scale [Neurosurgery Wiki]

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The **Glasgow-Liège Scale (GLS)** is an extension of the **Glasgow Coma Scale (GCS)**, incorporating **brainstem reflexes** to provide a more detailed assessment of coma severity. It was developed in **Liège, Belgium**, to improve neurological evaluation, particularly in **severe brain injuries**.

### **Components of the Glasgow-Liège Scale (GLS)**  
The GLS consists of two main parts:

1. **Glasgow Coma Scale (GCS) (Score: 3-15)**
   - **Eye Opening (E)** (1-4)
   - **Verbal Response (V)** (1-5)
   - **Motor Response (M)** (1-6)

2. **Brainstem Reflexes (Score: 0-5)**
   - **Oculocephalic Reflex (Doll’s eye reflex)**
   - **Pupillary Light Reflex**
   - **Oculovestibular Reflex (Caloric test)**
   - **Corneal Reflex**
   - **Cough Reflex (via tracheal stimulation)**  
   Each reflex is scored as **0 (absent) or 1 (present)**.

### **Total Score: 3 to 20**
- The **GCS score** ranges from **3 to 15**.
- The **brainstem reflexes** add **0 to 5 points**.
- **Total GLS Score = GCS + Brainstem Reflex Score (3 to 20).**

### **Clinical Significance**
- **Better prognostic value** than GCS alone, especially in deep coma.
- Helps distinguish **brain death** (score of 3 with all reflexes absent).
- Useful in **ICU and neurosurgical settings** for monitoring coma evolution.