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Instructions: Only horizontal eye movements will be tested. Voluntary or reflexive (oculocephalic) eye movements will be scored, but caloric testing is not done. If the patient has a conjugate deviation of the eyes that can be overcome by voluntary or reflexive activity, the score will be 1.
NIH STROKE SCALE IN PLAIN ENGLISH 1a. Level of Consciousness 0= Alert 1= Sleepy but arouses 2= Can’t stay awake 3= No purposeful response or reflexive motor only (comatose) 1b. Questions (month, age) 0=Both correct 1=One correct /intubated 2=Neither correct (comatose) 1c. Commands ...
NIH STROKE SCALE 1.a. Level of Consciousness: 1.b. Ask patient the month and their age: 1.c. Ask patient to open and close eyes and grip and release non-paretic hand. 2. Best gaze (only horizontal eye
Asked to show teeth & raise eyebrows. 5. Motor Arm. Asked to extend arms (palm down) 90o (if sitting) or 45o (if supine) & hold for 10 seconds. Begin with non-paretic limb. 6. Motor Leg. While supine, asked to hold leg at 30o for 5 seconds. 7.Limb Ataxia. Finger – nose & heel – shin test on both sides.
Administer stroke scale items in the order listed. Record performance in each category after each subscale exam. Do not go back and change scores. Follow directions provided for each exam technique. Scores should reflect what the patient does, not what the clinician thinks the patient can do. The clinician should record answers while
NIH Stroke Scale. with notes for the comatose and intubated patients. Comatose Patient: Defined by a patient with a 3 on item 1a (LOC) Is a patient that makes no movement (other than reflexive posturing) in response to noxious stimulation. Can only score items 2 & 3 (oculocephalic move and blink to threat)
NIH Stroke Scale Reference booklet for health professionals who administer the NIH Stroke Scale \(NIHSS\) to stroke patients.
