APEX NIH Stroke Scale GROUP F - 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 F1
Total Score: 4
Severity: Minor Stroke
Dominant Deficit Pattern: Mild right arm weakness, mild facial palsy, mild
cognitive impairment (one question incorrect), and mild dysarthria. All other
domains are intact.
Item Domain Score Clinical Description
1a LOC 0 Fully alert.
1b LOC Questions 1 Answers one 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 1 Mild drift; arm drifts down before 10 seconds
(Right) but does not hit bed.
6a Motor Leg (Left) 0 No drift; normal strength.
6b Motor Leg (Right) 0 No drift; normal strength.
pg. 1
, 7 Limb Ataxia 0 No ataxia.
8 Sensory 0 Normal sensation.
9 Best Language 0 No aphasia.
10 Dysarthria 1 Mild-to-moderate slurring; speech is still
understandable.
11 Extinction/Neglect 0 No neglect or inattention.
Patient F2 - Highest Acuity in Group F
Total Score: 18
Severity: Moderate-to-Severe Stroke
Dominant Deficit Pattern: Dense right hemiplegia (arm and leg completely
flaccid) with complete visual field loss, severe aphasia, severe sensory loss,
dysarthria, and cognitive impairment. Requires urgent, aggressive intervention.
Item Domain Score Clinical Description
1a LOC 0 Fully alert.
1b LOC Questions 2 Significant: Answers neither question
correctly.
1c LOC Commands 1 Performs one command correctly.
2 Best Gaze 0 Normal horizontal eye movements.
3 Visual Fields 2 Significant: Complete hemianopia.
4 Facial Palsy 0 Normal symmetrical movement.
5a Motor Arm (Left) 0 No drift; normal strength.
5b Motor Arm 4 Critical: No movement at all (flaccid).
(Right)
6a Motor Leg (Left) 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 F1
Total Score: 4
Severity: Minor Stroke
Dominant Deficit Pattern: Mild right arm weakness, mild facial palsy, mild
cognitive impairment (one question incorrect), and mild dysarthria. All other
domains are intact.
Item Domain Score Clinical Description
1a LOC 0 Fully alert.
1b LOC Questions 1 Answers one 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 1 Mild drift; arm drifts down before 10 seconds
(Right) but does not hit bed.
6a Motor Leg (Left) 0 No drift; normal strength.
6b Motor Leg (Right) 0 No drift; normal strength.
pg. 1
, 7 Limb Ataxia 0 No ataxia.
8 Sensory 0 Normal sensation.
9 Best Language 0 No aphasia.
10 Dysarthria 1 Mild-to-moderate slurring; speech is still
understandable.
11 Extinction/Neglect 0 No neglect or inattention.
Patient F2 - Highest Acuity in Group F
Total Score: 18
Severity: Moderate-to-Severe Stroke
Dominant Deficit Pattern: Dense right hemiplegia (arm and leg completely
flaccid) with complete visual field loss, severe aphasia, severe sensory loss,
dysarthria, and cognitive impairment. Requires urgent, aggressive intervention.
Item Domain Score Clinical Description
1a LOC 0 Fully alert.
1b LOC Questions 2 Significant: Answers neither question
correctly.
1c LOC Commands 1 Performs one command correctly.
2 Best Gaze 0 Normal horizontal eye movements.
3 Visual Fields 2 Significant: Complete hemianopia.
4 Facial Palsy 0 Normal symmetrical movement.
5a Motor Arm (Left) 0 No drift; normal strength.
5b Motor Arm 4 Critical: No movement at all (flaccid).
(Right)
6a Motor Leg (Left) 0 No drift; normal strength.
pg. 2
