GCS Scores and Encephalopathy

Does anyone have any medical literature that will definitively provide and cite corresponding GCS scores that are used to provide evidence and support for ‘encephalopathy’. I know the clinical definition for encephalopathy, and I understand that GCS scores of 8 or so are commonly used for the condition of ‘coma’.  Can GCS scores be used with precision to diagnosis (and defend the diagnosis) of encephalopathy?  Thanks!

Paul Evans, RHIA, CCDS


  • interesting question paul- I have never seen anything like that. I think it would be difficult as encephalopathy can present in varied ways. The patient may be lethargic and slow to respond, or may be hyperconfused and agitated.
  • AS far as I am aware, GSC scores and a dx of encephalopathy do not cross walk.  A low score may support clinically validity of an encephalopathy diagnosis of course, if it were of CNS origin or one of the chronic progressive types etc. I would not think it to assign a GSC score appropriate with something as transient as hypoglycemic/hypertensive/transient hypoxic and some of the metabolic's unless they were also in the ICU with a catastrophic neurological problem of a multi factorial nature.  I also would not think a GSC would be appropriate in something like an end stage alzhiemers patient who's presentation was pre-existing and they just happened to be in the ICU.
  • Thank you for the thoughtful responses. I should have clarified I am referring to forms of encephalopathy that would be of acute onset in the setting of something such as sepsis. I agree with the points made - particularly the different presentations seen with different types of encephalopathy. I was weakly optimistic I had overlooked some type of clinical cross walk for this subjective condition. Paul
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