The pediatric coma scale differs from the Glasgow Coma Scale in that it includes which of the following?

• A. Eye opening.
• B. Verbal response.
• C. Pupil reactivity.
• D. Intracranial pressure measurement.

Answer: (C)

Pupillary reactivity is a direct, non-behavioral sign of brainstem function. The Glasgow Coma Scale measures consciousness level through observable actions: eye opening, verbal response, and motor response, but it doesn’t assess how the pupils react to light. In the pediatric version, eye opening and motor/verbal responses are still evaluated, but pupil reactivity is added to capture brainstem status, which can provide important information about neurological function in children who may not cooperate or produce reliable verbal responses. A pupil that reacts to light, is sluggish, or is fixed offers a separate, objective clue about the patient's neurologic status and helps monitor changes over time. Intracranial pressure measurement, while important, is not part of these bedside scales.