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NIH Stroke Scale Questions and Answers
How to assess Level of Consciousness?
Ans: 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?
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Ans: 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?
Ans: 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?
© 2025 All rights reserved
NIH Stroke Scale Questions and Answers
How to assess Level of Consciousness?
Ans: 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?
© 2025 All rights reserved
, 2 | Page
Ans: 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?
Ans: 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?
© 2025 All rights reserved
