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MSH
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MSSM/MSW
MS Downtown
MS Queens
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NIH Stroke Scale
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Range
Description
Category
<5
Low risk. Favorable clinical outcome
good
5-42
Moderate risk
bad
1. Level of Consciousness
Alert, keenly responsive [0]
Arouses to minor stimulation
Requires repeated stimulation to arouse
Movements to pain
Postures or Unresponsive
2. Ask Month and Age
Both Questions Right [0]
1 Question Right
0 Questions Right
Dysarthric/Intubated/Trauma/Language Barrier
Aphasic
3. 'Blink Eyes' & 'Squeeze Hands' (pantomime commands if communication barrier)
Performs Both Tasks [0]
Performs 1 Task
Performs 0 Tasks
4. Test Horizontal Extraocular Movements
Normal [0]
Partial Hemianopia
Complete Hemianopia
Patient is Bilaterally Blind
Bilateral Hemianopia
5. Test Facial Palsy (Use Grimace if obtunded)
No Drift for 10 seconds [0]
Drift, but doesn't hit bed
Drifts, hits bed
Some Effort Against Gravity
No Effort Against Gravity
No Movement
Amputation/Joint Fusion [0]
6. Test Right Arm Motor Drift
No Drift for 5 seconds [0]
Drift, but doesn't hit bed
Drift, hits bed
Some Effort Against Gravity
No Effort Against Gravity
No Movement
Amputation/Joint Fusion [0]
7. Test Limb Ataxia (FNF/Heel-Shin)
No Ataxia [0]
Ataxia in 1 Limb
Ataxia in 2 Lims
Does Not Understand [0]
Paralyzed [0]
Amputation/Joint Fusion [0]
8. Test Sensation
Normal; No sensory loss [0]
Mild-Moderate Loss: Less Sharp/More Dull
Mild-Moderate Loss: Can Sense Being Touched
No Response and Quadriplegic
Coma/Unresponsive
9. Test Language/Aphasia (Describe the scene, name the words, read the sentences, in the image at the bottom)
Normal; No aphasia [0]
Mild-Moderate Aphasia: Some Obvious Changes, Without Significant Limitation
Severe Aphasia: Fragmentary Expression, Inference Needed, Cannot Identify Materials
Mute/Global Aphasia: No Usable Speech/Auditory Comprehension
Coma/Unresponsive
10. Test Dysarthria. Read the words in the image at the bottom.
Normal [0]
Mild-Moderate Dysarthria: Slurring but can be understood
Severe Dysarthria: Unintelligible Slurring or Out of Proportion to Dysphasia
Mute/Anarthric
Intubated/Unable to Test [0]
11. Test Extinction/Inattention
No Abnormality [0]
Visual/tactile/auditory/spatial/personal inattention
Extinction to bilateral simultaneous stimulation
Profound hemi-inattention (ex: does not recognize own hand)
Extinction to >1 Modality
