Table 3

The FOUR Score

Eye response
 4 = Eyelids open or opened, tracking or blinking to command
 3 = Eyelids open but not tracking
 2 = Eyelids closed but open to loud voice
 1 = Eyelids closed but open to pain
 0 = Eyelids remain closed with pain
Motor response
 4 = Thumbs-up, fist or peace sign
 3 = Localising to pain
 2 = Flexion response to pain
 1 = Extension response to pain
 0 = No response to pain, or generalised myoclonus status
Brainstem reflexes
 4 = Pupil and corneal reflexes present
 3 = One pupil wide and fixed
 2 = Pupil or corneal reflexes absent
 1 = Pupil and corneal reflexes absent
 0 = Absent pupil, corneal and cough reflex
Respiration
 4 = Not intubated, regular breathing pattern
 3 = Not intubated, Cheyne–Stokes breathing pattern
 2 = Not intubated, irregular breathing
 1 = Breathes above ventilator rate
 0 = Breathes at ventilator rate or apnoea