NIH Stroke Scale Exam Questions and Answers
What are the results? - Answer-0 = No visual loss.
1 = Partial hemianopia.
2 = Complete hemianopia.
3 = Bilateral hemianopia (blind including cortical blindness).
How to assess facial palsy? - Answer-Ask - or use pantomime to encourage - the pa...
NIH Stroke Scale Exam Questions
and Answers
What are the results? - Answer-0 = No visual loss.
1 = Partial hemianopia.
2 = Complete hemianopia.
3 = Bilateral hemianopia (blind including cortical blindness).
How to assess facial palsy? - Answer-Ask - or use pantomime to encourage - the
patient
to show teeth or raise eyebrows and close eyes. Score symmetry of grimace in
response to noxious stimuli in the poorly responsive or non-comprehending patient.
What are the results? - Answer-0 = Normal symmetrical movements.
1 = Minor paralysis (flattened nasolabial fold, asymmetry on
smiling).
2 = Partial paralysis (total or near-total paralysis of lower
face).
3 = Complete paralysis of one or both sides (absence of
facial movement in the upper and lower face)
How to assess motor arm and leg? - Answer-The limb is placed in the appropriate
position: extend
the arms (palms down) 90 degrees (if sitting) or 45 degrees (if supine). Drift is scored if
the arm falls before 10 seconds. The aphasic patient is encouraged using urgency in
the voice and pantomime, but not noxious stimulation. Each limb is tested in turn,
beginning with the non-paretic arm.
What are the results? - Answer-0 = No drift; limb holds 90 (or 45) degrees for full 10
seconds.
1 = Drift; limb holds 90 (or 45) degrees, but drifts down before
full 10 seconds; does not hit bed or other support.
2 = Some effort against gravity; limb cannot get to or
maintain (if cued) 90 (or 45) degrees, drifts down to bed,
but has some effort against gravity.
3 = No effort against gravity; limb falls.
4 = No movement.
UN = Amputation or joint fusion, explain:
Same as 5 - Answer-Same as 5
What are the results? - Answer-0 = No drift; limb holds 90 (or 45) degrees for full 10
seconds.
, 1 = Drift; limb holds 90 (or 45) degrees, but drifts down before
full 10 seconds; does not hit bed or other support.
2 = Some effort against gravity; limb cannot get to or
maintain (if cued) 90 (or 45) degrees, drifts down to bed,
but has some effort against gravity.
3 = No effort against gravity; limb falls.
4 = No movement.
UN = Amputation or joint fusion, explain:
How to assess limb ataxia? - Answer-This item is aimed at finding evidence of a
unilateral
cerebellar lesion. Test with eyes open. In case of visual defect, ensure testing is done in
intact visual field. The finger-nose-finger and heel-shin tests are performed on both
sides, and ataxia is scored only if present out of proportion to weakness. Ataxia is
absent in the
patient who cannot understand or is paralyzed.
What are the results? - Answer-0 = Absent.
1 = Present in one limb.
2 = Present in two limbs.
UN = Amputation or joint fusion, explain
How to assess sensory? - Answer-Sensation or grimace to pinprick when tested, or
withdrawal from noxious stimulus in the obtunded or aphasic patient.
Only sensory loss attributed to stroke is scored as abnormal and the examiner should
test as many body areas (arms [not hands], legs, trunk, face) as needed to accurately
check for hemisensory loss.
A score of 2, "severe or total sensory loss," should only be given when a severe or total
loss of sensation can be clearly demonstrated.
How to assess Level of Consciousness? - Answer-1a. Deteremine if patient is alert,
oriented x4
1b. The patient is asked the month and his/her age.
The answer must be correct - there is no partial credit for being close. Aphasic and
stuporous patients who do not comprehend the questions will score 2. It is important
that only the initial answer be graded and that the examiner not "help" the patient with
verbal or non-verbal cue.
1c. The patient is asked to open and close the
eyes and then to grip and release the non-paretic hand. If the patient does not respond
to command, the task
should be demonstrated to him or her (pantomime), and the result scored (i.e., follows
none, one or two commands)
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