APEX NIH Stroke Scale GROUP D - Answer
Key for Patients 1 through 6 (100% Correct
Answers) | Complete NIHSS Clinical Case
Series with Scores, Severity & Deficit
Analysis | Latest Edition – Updated 2026
Patient D1
Total Score: 9
Severity: Moderate Stroke
Dominant Deficit Pattern: Severe left arm weakness, moderate sensory loss, mild
neglect, and mild ataxia.
Item Domain Score Clinical Description
1a LOC 0 Fully alert.
1b LOC Questions 0 Answers both correctly.
1c LOC Commands 0 Performs both commands.
2 Best Gaze 0 Normal horizontal eye movements.
3 Visual Fields 0 No visual loss.
4 Facial Palsy 1 Minor facial asymmetry.
5a Motor Arm (Left) 3 Significant: Arm falls immediately; no effort
against gravity.
5b Motor Arm 0 No drift; normal strength.
(Right)
6a Motor Leg (Left) 1 Mild drift; leg falls before 5 seconds but does
not hit bed.
6b Motor Leg (Right) 0 No drift; normal strength.
pg. 1
, 7 Limb Ataxia 1 Ataxia present in one limb.
8 Sensory 2 Severe: Total or near-total sensory loss.
9 Best Language 0 No aphasia.
10 Dysarthria 0 Normal articulation.
11 Extinction/Neglect 1 Mild inattention or extinction to one sensory
modality.
Patient D2
Total Score: 7
Severity: Moderate Stroke
Dominant Deficit Pattern: Moderate-to-severe aphasia with dysarthria, mild
facial weakness, and mild sensory loss. Notably, no motor weakness in the limbs.
Item Domain Score Clinical Description
1a LOC 0 Fully alert.
1b LOC Questions 2 Significant: Answers neither question
correctly.
1c LOC Commands 0 Performs both commands.
2 Best Gaze 0 Normal horizontal eye movements.
3 Visual Fields 0 No visual loss.
4 Facial Palsy 1 Minor facial asymmetry.
5a Motor Arm (Left) 0 No drift; normal strength.
5b Motor Arm 0 No drift; normal strength.
(Right)
6a Motor Leg (Left) 0 No drift; normal strength.
6b Motor Leg (Right) 0 No drift; normal strength.
pg. 2
Key for Patients 1 through 6 (100% Correct
Answers) | Complete NIHSS Clinical Case
Series with Scores, Severity & Deficit
Analysis | Latest Edition – Updated 2026
Patient D1
Total Score: 9
Severity: Moderate Stroke
Dominant Deficit Pattern: Severe left arm weakness, moderate sensory loss, mild
neglect, and mild ataxia.
Item Domain Score Clinical Description
1a LOC 0 Fully alert.
1b LOC Questions 0 Answers both correctly.
1c LOC Commands 0 Performs both commands.
2 Best Gaze 0 Normal horizontal eye movements.
3 Visual Fields 0 No visual loss.
4 Facial Palsy 1 Minor facial asymmetry.
5a Motor Arm (Left) 3 Significant: Arm falls immediately; no effort
against gravity.
5b Motor Arm 0 No drift; normal strength.
(Right)
6a Motor Leg (Left) 1 Mild drift; leg falls before 5 seconds but does
not hit bed.
6b Motor Leg (Right) 0 No drift; normal strength.
pg. 1
, 7 Limb Ataxia 1 Ataxia present in one limb.
8 Sensory 2 Severe: Total or near-total sensory loss.
9 Best Language 0 No aphasia.
10 Dysarthria 0 Normal articulation.
11 Extinction/Neglect 1 Mild inattention or extinction to one sensory
modality.
Patient D2
Total Score: 7
Severity: Moderate Stroke
Dominant Deficit Pattern: Moderate-to-severe aphasia with dysarthria, mild
facial weakness, and mild sensory loss. Notably, no motor weakness in the limbs.
Item Domain Score Clinical Description
1a LOC 0 Fully alert.
1b LOC Questions 2 Significant: Answers neither question
correctly.
1c LOC Commands 0 Performs both commands.
2 Best Gaze 0 Normal horizontal eye movements.
3 Visual Fields 0 No visual loss.
4 Facial Palsy 1 Minor facial asymmetry.
5a Motor Arm (Left) 0 No drift; normal strength.
5b Motor Arm 0 No drift; normal strength.
(Right)
6a Motor Leg (Left) 0 No drift; normal strength.
6b Motor Leg (Right) 0 No drift; normal strength.
pg. 2
