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Table 65.2

National Institute of Health Stroke Score (NIHSS). This Should Be Completed on All Patients with Stroke to Ensure that the Stroke Deficits are Collected in a Systematic Way and the Less Obvious Signs of Stroke are Not Missed

Level of consciousness

Alert

Not alert, but arousable with minor stimuli

Not alert, needs repeated stimuli

Coma

0

1

23

Level of consciousness questions

Answers both correctly

Answers one correctly

Answers both incorrectly

0

12

Level of consciousness commands

Performs both correctly

Performs one correctly

Performs neither correctly

0

12

Best gaze

Normal

Partial gaze palsy

Forced deviation

0

12

Visual field testing

No visual loss

Partial hemianopia

Complete hemianopia

Bilateral hemianopia

0

1

23

Facial paresis

Normal facial movements

Minor paralysis

Partial paralysis

Complete paralysis of one or both sides

0

1

23

Right arm motor function

No drift

Drift

Some effort against gravity

No effort against gravity

No movement

0

1

2

34

Left arm motor function

No drift

Drift

Some effort against gravity

No effort against gravity

No movement

0

1

2

34

Right leg motor function

No drift

Drift

Some effort against gravity

No effort against gravity

No movement

0

1

2

34

Left leg motor function

No drift

Drift

Some effort against gravity

No effort against gravity

No movement

0

1

2

34

Limb ataxia

Absent

Present one limb

Present two limbs

0

12

Sensory

Normal

Mild to moderate loss

Severe to total

0

12

Best language

Normal

Mild to moderate aphasia

Severe aphasia

Mute

0

1

23

Dysarthria

Normal

Mild to moderate

Severe/mute/anarthric

0

12

Extinction/inattention

No abnormality

Visual, tactile, auditory or personal inattention

Profound hemi inattention of extinction to more than one modality

0

12