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Calculator: National Institutes of Health Stroke Scale (NIHSS) score in adults


Calculator: National Institutes of Health Stroke Scale (NIHSS) score in adults

 
Level of consciousness

Alert (0 points)

Not alert, but arousable with minimal stimulation (1 point)

Not alert, requires repeated stimulation to attend (2 points)

Responds only with reflex motor or autonomic effects or totally unresponsive, flaccid, and areflexic (3 points)
Patient knows month and own age

Answers both correctly (0 points)

Answers one correctly (1 point)

Both incorrect (2 points)
Patient opens and closes eyes and grips and releases the nonparetic hand on command

Obeys both correctly (0 points)

Obeys one correctly (1 point)

Both incorrect (2 points)
Best gaze (only horizontal eye movement)

Normal (0 points)

Partial gaze palsy (1 point)

Forced deviation (2 points)
Visual field testing

No visual loss (0 points)

Partial hemianopia (1 point)

Complete hemianopia (2 points)

Bilateral hemianopia (blind including cortical blindness) (3 points)
Facial paresis (ask patient to show teeth or raise eyebrows and close eye)

Normal symmetrical movement (0 points)

Minor paralysis (flattened nasolabial fold, asymmetry on smiling) (1 point)

Partial paralysis (total or near total paralysis of lower face) (2 points)

Complete paralysis of one or both sides (3 points)
Motor function of right arm

No drift (0 points)

Drift (1 point)

Some effort against gravity (2 points)

No effort against gravity (3 points)

No movement (4 points)

Untestable (amputation or joint fusion at the shoulder) (0 points)
Motor function of left arm

No drift (0 points)

Drift (1 point)

Some effort against gravity (2 points)

No effort against gravity (3 points)

No movement (4 points)

Untestable (amputation or joint fusion at the shoulder) (0 points)
Motor function of right leg

No drift (0 points)

Drift (1 point)

Some effort against gravity (2 points)

No effort against gravity (3 points)

No movement (4 points)

Untestable (amputation or joint fusion at the hip) (0 points)
Motor function of left leg

No drift (0 points)

Drift (1 point)

Some effort against gravity (2 points)

No effort against gravity (3 points)

No movement (4 points)

Untestable (amputation or joint fusion at the hip) (0 points)
Limb ataxia

Absent (0 points)

Present in one limb (1 point)

Present in two limbs (2 points)

Untestable (amputation or joint fusion) (0 points)
Sensory to pinprick or withdrawal from noxious stimulus

Normal (0 points)

Mild to moderate sensory loss (1 point)

Severe to total sensory loss (2 points)
Language

No aphasia (0 points)

Mild to moderate aphasia (1 point)

Severe aphasia (2 points)

Mute, global aphasia (3 points)
Dysarthria

None (0 points)

Mild to moderate dysarthria (1 point)

Severe dysarthria (2 points)

Intubated or other physical barrier to producing speech (0 points)
Extinction and inattention

No abnormality (0 points)

Visual, tactile, auditory, spatial, or personal inattention or extinction to bilateral simultaneous stimulation in one of the sensory modalities (1 point)

Profound hemi-inattention or extinction to more than one modality (2 points)

 
Important: Inputs must be complete to perform calculation.

 
Total criteria point count:
 
Notes
  • This calculator is best used by a certified NIHSS examiner in conjunction with a copy of the full NIHSS, which provides a detailed description of how to test for each criterion and is available at the NIH website.

 
Only digits 0 to 9 and a single decimal point (".") are acceptable as numeric inputs. Attempted input of other characters into a numeric field may lead to an incorrect result.

Information on this page may not appear correctly if printed.

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