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1b. Nivel de conciencia Preguntas verbales ¿En qué mes vivimos? ¿Qué edad tiene? 1c. Nivel de conciencia. Órdenes motoras 1.Cierre los ojos, después ábralos. 2.Cierre la mano, después ábrala. 2. Mirada conjugada (voluntariamente o reflejos óculocefálicos, no permitidos óculovestibulares) Si lesión de un nervio periférico: 1punto. 3. Campos visuales (confrontación) Si ceguera bilateral de cualquier causa: 3 puntos. Si extinción visual: 1 puntos 4. Paresia facial
5. Paresia de extremidades superiores (ES) Se explora 1º la ES no parética Debe levantar el brazo extendido a 45º (decúbito) ó a 90º (sentado). No se evalúa la fuerza distal Se puntúa cada lado por separado. El 9 no se contabiliza en el cómputo global. 6. Paresia de extremidades inferiores (EI) Se explora 1º la EI no patética. Debe levantar la pierna extendida y mantener a 30º. Se puntúa cada lado por separado. El 9 no se contabiliza en el cómputo global. 7. Ataxia de las extremidades. Dedo-nariz y talón-rodilla. Si déficit motor que impida medir dismetría: 0 pt. 8. Sensibilidad. Si obnubilado evaluar la retirada al estímulo doloroso. Si déficit bilateral o coma: 2 puntos. 9. Lenguaje. Si coma: 3 puntos. Si intubación o anartria: explorar por escritura. 10. Disartria. Si afasia: 3 puntos
11. Extinción-NegligenciaInatención. Si coma: 2 puntos.
TOTAL
Fechas/hora: Alerta 0 Somnolencia 1 Obnubilación 2 Coma 3 Ambas respuestas son correctas 0 Una respuesta correcta 1 Ninguna respuesta correcta 2
0 1 2 3 0 1 2
0 1 2 3 0 1 2
0 1 2 3 0 1 2
0 1 2 3 0 1 2
0 1 2 3 0 1 2
0 1 2 3 0 1 2
0 1 2 3 0 1 2
0 1 2 3 0 1 2
Ambas respuestas son correctas Una respuesta correcta Ninguna respuesta correcta
0 1 2
0 1 2
0 1 2
0 1 2
0 1 2
0 1 2
0 1 2
0 1 2
0 1 2
Normal Paresia parcial de la mirada Paresia total o desviación forzada
0 1 2
0 1 2
0 1 2
0 1 2
0 1 2
0 1 2
0 1 2
0 1 2
0 1 2
Normal Hemianopsia parcial Hemianopsia completa Ceguera bilateral Normal. Paresia leve (asimetría al sonreír.) Parálisis total de músc. facial inferior Parálisis total de músc facial superior e inferior. Mantiene la posición 10”. Claudica en menos de 10” sin llegar a tocar la cama. Claudica y toca la cama en menos de 10”. Hay movimiento pero no vence gravedad. Parálisis completa.. Extremidad amputada o inmovilizada
0 1 2 3 0 1 2 3
0 1 2 3 0 1 2 3
0 1 2 3 0 1 2 3
0 1 2 3 0 1 2 3
0 1 2 3 0 1 2 3
0 1 2 3 0 1 2 3
0 1 2 3. 0 1 2 3
0 1 2 3. 0 1 2 3
0 1 2 3. 0 1 2 3
0 1 2 3 4 9
0 1 2 3 4 9
0 1 2 3 4 9
0 1 2 3 4 9
0 1 2 3 4 9
0 1 2 3 4 9
0 1 2 3 4 9
0 1 2 3 4 9
0 1 2 3 4 9
Mantiene la posición 5”. Claudica en menos de 5” sin llegar a tocar la cama. Claudica y toca la cama en menos de 5”. Hay movimiento pero no vence gravedad. Parálisis completa. Extremidad amputada o inmovilizada. Normal. Ataxia en una extremidad. Ataxia en dos extremidades.
0 1 2 3 4 9
0 1 2 3 4 9
0 1 2 3 4 9
0 1 2 3 4 9
0 1 2 3 4 9
0 1 2 3 4 9
0 1 2 3 4 9
0 1 2 3 4 9
0 1 2 3 4 9
0 1 2
0 1 2
0 1 2
0 1 2
0 1 2
0 1 2
0 1 2
0 1 2
0 1 2
Normal Leve o moderada hipoestesia. Anestesia.
0 1 2
0 1 2
0 1 2
0 1 2
0 1 2
0 1 2
0 1 2
0 1 2
0 1 2
Normal. Afasia leve o moderada. Afasia grave, no posible entenderse. Afasia global o en coma Normal. Leve, se le puede entender. Grave, ininteligible o anartria. Intubado. No puntúa. Normal. Inatención/extinción en una modalidad Inatención/extinción en más de una modalidad.
