NIH STROKE SCALE 2025 REVISED
VERSION || APEX NIH STROKE SCALE- ALL
TEST GROUPS A-F (PATIENT 1-6
COMPLETE)
How to assess Level of Consciousness? Correct Answer 1a.
Deteremine if patient is alert, oriented x4
1b. The patient is asked the month and his/her age.
The answer must be correct - there is no partial credit for being
close. Aphasic and stuporous patients who do not comprehend
the questions will score 2. It is important that only the initial
answer be graded and that the examiner not "help" the patient
with verbal or non-verbal cue.
1c. The patient is asked to open and close the
eyes and then to grip and release the non-paretic hand. If the
patient does not respond to command, the task
should be demonstrated to him or her (pantomime), and the result
scored (i.e., follows none, one or two commands)
What are the results? Correct Answer 0 = Alert; keenly
responsive.
1 = Not alert; but arousable by minor stimulation to obey,
, answer, or respond.
2 = Not alert; requires repeated stimulation to attend, or is
obtunded and requires strong or painful stimulation to
make movements (not stereotyped).
3 = Responds only with reflex motor or autonomic effects or totally
unresponsive, flaccid, and areflexic.
0 = Answers both questions correctly.
1 = Answers one question correctly.
2 = Answers neither question correctly
0 = Performs both tasks correctly.
1 = Performs one task correctly.
2 = Performs neither task correctly.
How to assess best gaze? Correct Answer Only horizontal eye
movements will be tested.
Voluntary or reflexive (oculocephalic) eye movements will be
scored, but caloric testing is not done. If the patient has a
conjugate deviation of the eyes that can be overcome by
voluntary or reflexive activity, the score will be 1If a patient has an
isolated peripheral nerve paresis (CN III, IV or VI), score a 1
What are the results? Correct Answer 0 = Normal.
VERSION || APEX NIH STROKE SCALE- ALL
TEST GROUPS A-F (PATIENT 1-6
COMPLETE)
How to assess Level of Consciousness? Correct Answer 1a.
Deteremine if patient is alert, oriented x4
1b. The patient is asked the month and his/her age.
The answer must be correct - there is no partial credit for being
close. Aphasic and stuporous patients who do not comprehend
the questions will score 2. It is important that only the initial
answer be graded and that the examiner not "help" the patient
with verbal or non-verbal cue.
1c. The patient is asked to open and close the
eyes and then to grip and release the non-paretic hand. If the
patient does not respond to command, the task
should be demonstrated to him or her (pantomime), and the result
scored (i.e., follows none, one or two commands)
What are the results? Correct Answer 0 = Alert; keenly
responsive.
1 = Not alert; but arousable by minor stimulation to obey,
, answer, or respond.
2 = Not alert; requires repeated stimulation to attend, or is
obtunded and requires strong or painful stimulation to
make movements (not stereotyped).
3 = Responds only with reflex motor or autonomic effects or totally
unresponsive, flaccid, and areflexic.
0 = Answers both questions correctly.
1 = Answers one question correctly.
2 = Answers neither question correctly
0 = Performs both tasks correctly.
1 = Performs one task correctly.
2 = Performs neither task correctly.
How to assess best gaze? Correct Answer Only horizontal eye
movements will be tested.
Voluntary or reflexive (oculocephalic) eye movements will be
scored, but caloric testing is not done. If the patient has a
conjugate deviation of the eyes that can be overcome by
voluntary or reflexive activity, the score will be 1If a patient has an
isolated peripheral nerve paresis (CN III, IV or VI), score a 1
What are the results? Correct Answer 0 = Normal.
