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)

1. Eye Opening (E) (1-4)
2. Verbal Response (V) (1-5)
3. Motor Response (M) (1-6)

2. Brainstem Reflexes (Score: 0-5)

1. Oculocephalic Reflex (Doll’s eye reflex)
2. Pupillary Light Reflex
3. Oculovestibular Reflex (Caloric test)
4. Corneal Reflex
5. 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.