2026 APEX NIH Stroke Scale Group
A Patients 1–6 (Complete) – Verified
Answers
APEX NIH Stroke Scale (NIHSS)
Group A - Patients 1-6
NIHSS ITEMS (REFERENCE)
1. 1a. Level of Consciousness (LOC)
2. 1b. LOC Questions
3. 1c. LOC Commands
4. 2. Best Gaze
5. 3. Visual Fields
6. 4. Facial Palsy
7. 5. Motor Arm (L/R)
8. 6. Motor Leg (L/R)
9. 7. Limb Ataxia
10. 8. Sensory
, 11. 9. Best Language
12. 10. Dysarthria
13. 11. Extinction & Inattention (Neglect)
Patient 1 - Normal Neurologic Status
Scores
1a LOC: 0
1b LOC Questions: 0
1c LOC Commands: 0
2 Best Gaze: 0
3 Visual Fields: 0
4 Facial Palsy: 0
5 Motor Arms (L/R): 0
6 Motor Legs (L/R): 0
7 Limb Ataxia: 0
8 Sensory: 0
9 Best Language: 0
10 Dysarthria: 0
11 Neglect: 0
Total NIHSS: 0
Rationale: The patient is alert, follows commands, answers questions correctly,
and demonstrates no focal neurologic deficits. A total score of 0 reflects no
evidence of acute stroke-related impairment.
,Patient 2 - Mild Expressive Aphasia
Scores
1a LOC: 0
1b LOC Questions: 0
1c LOC Commands: 0
2 Best Gaze: 0
3 Visual Fields: 0
4 Facial Palsy: 0
5 Motor Arms (L/R):
6 Motor Legs (L/R):
7 Limb Ataxia: 0
8 Sensory: 0
9 Best Language: 1
10 Dysarthria: 0
11 Neglect: 0
Total NIHSS: 1
Rationale: Speech is fluent but with word-finding difficulty. The patient
communicates ideas but with mild impairment. An NIHSS language score of 1
reflects mild aphasia without loss of meaningful communication.
Patient 3 - Right Arm Drift
Scores (Image placeholders omitted)
Total NIHSS: 2
, Rationale: The right arm cannot maintain position against gravity and drifts down
before 10 seconds, meeting criteria for a score of 2. No additional neurologic
deficits are present.
Patient 4 - Left Facial Droop & Slurred Speech
Scores
1a LOC: 0
1b LOC Questions: 0
1c LOC Commands: 0
2 Best Gaze: 0
3 Visual Fields: 0
4 Facial Palsy: 2
5 Motor Arms (L/R):
6 Motor Legs (L/R):
7 Limb Ataxia: 0
8 Sensory: 0
9 Best Language: 0
10 Dysarthria: 1
11 Neglect: 0
Total NIHSS: 3
Rationale: There is partial lower facial paralysis, consistent with a facial palsy
score of 2. Speech is slurred but understandable, which qualifies as mild
dysarthria (1).
Patient 5 - Left Hemianopia
A Patients 1–6 (Complete) – Verified
Answers
APEX NIH Stroke Scale (NIHSS)
Group A - Patients 1-6
NIHSS ITEMS (REFERENCE)
1. 1a. Level of Consciousness (LOC)
2. 1b. LOC Questions
3. 1c. LOC Commands
4. 2. Best Gaze
5. 3. Visual Fields
6. 4. Facial Palsy
7. 5. Motor Arm (L/R)
8. 6. Motor Leg (L/R)
9. 7. Limb Ataxia
10. 8. Sensory
, 11. 9. Best Language
12. 10. Dysarthria
13. 11. Extinction & Inattention (Neglect)
Patient 1 - Normal Neurologic Status
Scores
1a LOC: 0
1b LOC Questions: 0
1c LOC Commands: 0
2 Best Gaze: 0
3 Visual Fields: 0
4 Facial Palsy: 0
5 Motor Arms (L/R): 0
6 Motor Legs (L/R): 0
7 Limb Ataxia: 0
8 Sensory: 0
9 Best Language: 0
10 Dysarthria: 0
11 Neglect: 0
Total NIHSS: 0
Rationale: The patient is alert, follows commands, answers questions correctly,
and demonstrates no focal neurologic deficits. A total score of 0 reflects no
evidence of acute stroke-related impairment.
,Patient 2 - Mild Expressive Aphasia
Scores
1a LOC: 0
1b LOC Questions: 0
1c LOC Commands: 0
2 Best Gaze: 0
3 Visual Fields: 0
4 Facial Palsy: 0
5 Motor Arms (L/R):
6 Motor Legs (L/R):
7 Limb Ataxia: 0
8 Sensory: 0
9 Best Language: 1
10 Dysarthria: 0
11 Neglect: 0
Total NIHSS: 1
Rationale: Speech is fluent but with word-finding difficulty. The patient
communicates ideas but with mild impairment. An NIHSS language score of 1
reflects mild aphasia without loss of meaningful communication.
Patient 3 - Right Arm Drift
Scores (Image placeholders omitted)
Total NIHSS: 2
, Rationale: The right arm cannot maintain position against gravity and drifts down
before 10 seconds, meeting criteria for a score of 2. No additional neurologic
deficits are present.
Patient 4 - Left Facial Droop & Slurred Speech
Scores
1a LOC: 0
1b LOC Questions: 0
1c LOC Commands: 0
2 Best Gaze: 0
3 Visual Fields: 0
4 Facial Palsy: 2
5 Motor Arms (L/R):
6 Motor Legs (L/R):
7 Limb Ataxia: 0
8 Sensory: 0
9 Best Language: 0
10 Dysarthria: 1
11 Neglect: 0
Total NIHSS: 3
Rationale: There is partial lower facial paralysis, consistent with a facial palsy
score of 2. Speech is slurred but understandable, which qualifies as mild
dysarthria (1).
Patient 5 - Left Hemianopia
