|
1a. LOC |
0 |
Alert |
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|
1 |
Drowsy |
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|
2 |
Stuporous |
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|
3 |
Comatose |
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|
1b. LOC questions |
0 |
Answers both questions correctly |
|
|
1 |
Answers 1 question correctly |
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|
2 |
Answers neither question correctly |
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|
1c. LOC commands |
0 |
Performs both tasks correctly |
|
|
1 |
Performs 1 task correctly |
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|
2 |
Performs neither task correctly |
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|
2. Best gaze |
0 |
Normal |
|
|
1 |
Partial gaze palsy |
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|
2 |
Forced deviation |
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|
3. Visual fields |
0 |
No visual loss (or in coma) |
|
|
1 |
Partial hemianopia |
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|
2 |
Complete hemianopia |
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|
3 |
Bilateral hemianopia |
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|
4. Facial palsy |
0 |
Normal |
|
|
1 |
Minor |
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|
2 |
Partial |
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|
3 |
Complete |
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|
5. Best motor: right arm |
0 |
No drift |
|
|
1 |
Drift |
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|
2 |
Some effort against gravity |
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|
3 |
No effort against gravity |
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|
4 |
No movement |
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|
6. Best motor: left arm |
0 |
No drift |
|
|
1 |
Drift |
||
|
2 |
Some effort against gravity |
||
|
3 |
No effort against gravity |
||
|
4 |
No movement |
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|
7. Best motor: right leg |
0 |
No drift |
|
|
1 |
Drift |
||
|
2 |
Some effort against gravity |
||
|
3 |
No effort against gravity |
||
|
4 |
No movement |
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|
8. Best motor: left leg |
0 |
No drift |
|
|
1 |
Drift |
||
|
2 |
Some effort against gravity |
||
|
3 |
No effort against gravity |
||
|
4 |
No movement |
||
|
9. Limb ataxia |
0 |
Absent (or in coma) |
|
|
1 |
Present in 1 limb |
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|
2 |
Present in ≥2 limbs |
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|
10. Sensory |
0 |
Normal |
|
|
1 |
Partial loss |
||
|
2 |
Dense loss (or in coma) |
||
|
11. Best language |
0 |
No dysphasia |
|
|
1 |
Mild |
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|
2 |
Severe dysphasia |
||
|
3 |
Mute |
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|
12. Dysarthria |
0 |
Normal articulation |
|
|
1 |
Mild to moderate dysarthria |
||
|
2 |
Unintelligible or worse |
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|
13. Neglect |
0 |
No neglect (or in coma) |
|
|
1 |
Partial neglect |
||
|
2 |
Complete neglect |
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|
NIHSS total score |
|
|
|
|
NIHSS scoring for aphasic and comatose patients: 1b. LOC questions: Aphasic and stuporous patients unable to state age or month = 2 points. 2. Best gaze: Conjugate gaze deviation overcome by voluntary or reflex movement = 1 point. Isolated eye nerve palsy = 1 point. 3. Visual fields: Visual field clear cut asymmetry = 1 point. Total blindness = 2 points. 4. Facial palsy: Facial asymmetry can be assessed in response to noxious stimuli. 5-8. Motor testing: Motor testing can be pantomimed for aphasic patients. 9. Limb ataxia: If cannot be demonstrated = 0 points. 10. Sensory: Asymmetry = 1 point. Bilateral sensory loss = 2 points. Patient in coma and with no response to pain = 2 points. 11. Best language: Patient in coma = 3 points. 12. Dysarthria: Scored only if audible speech is heard. 13. Neglect: Present if obviously more than blindness or sensory loss. |
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LOC, level of consciousness; NIHSS, National Institute of Health Stroke Scale. |
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