2026 APEX NIH Stroke Scale Group C
Patients 1-6 (Complete) - Verified
Answers
APEX NIH Stroke Scale (NIHSS)
Group C - 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 - Severe Right Hemispheric Stroke
Scores
1a LOC: 0
1b LOC Questions: 2
1c LOC Commands: 1
2 Best Gaze: 0
3 Visual Fields: 2
4 Facial Palsy: 1
5 Motor Arms (L/R):
6 Motor Legs (L/R):
7 Limb Ataxia: 1
8 Sensory: 2
9 Best Language: 2
10 Dysarthria: 1
11 Neglect: 1
Total NIHSS: [15+]
,Rationale: This patient presents with a severe right hemispheric stroke
characterized by left-sided paralysis (5b=4, 6b=4), significant visual loss
(3=2), severe sensory loss (8=2), and severe aphasia (9=2). The patient
is alert (1a=0) but answers neither LOC question correctly (1b=2) and
performs only one command (1c=1). This pattern is consistent with a large
cortical infarct affecting multiple motor and sensory pathways .
Patient 2 - Mild Motor & Sensory Deficit
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: 1
9 Best Language: 0
10 Dysarthria: 0
11 Neglect: 0
Total NIHSS: [4]
, Rationale: This patient demonstrates mild left leg drift (6a=1) and some
effort against gravity in the left leg (6b=2), along with mild-to-moderate
sensory loss (8=1). No facial palsy, aphasia, or neglect is present. This
represents a mild focal deficit stroke with primarily motor and sensory
involvement .
Patient 3 - Moderate Focal Deficit
Scores
1a LOC: 0
1b LOC Questions: 0
1c LOC Commands: 0
2 Best Gaze: 0
3 Visual Fields: 0
4 Facial Palsy: 1
5 Motor Arms (L/R):
6 Motor Legs (L/R):
7 Limb Ataxia: 1
8 Sensory: 1
9 Best Language: 0
10 Dysarthria: 0
11 Neglect: 0
Total NIHSS: [4]
Patients 1-6 (Complete) - Verified
Answers
APEX NIH Stroke Scale (NIHSS)
Group C - 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 - Severe Right Hemispheric Stroke
Scores
1a LOC: 0
1b LOC Questions: 2
1c LOC Commands: 1
2 Best Gaze: 0
3 Visual Fields: 2
4 Facial Palsy: 1
5 Motor Arms (L/R):
6 Motor Legs (L/R):
7 Limb Ataxia: 1
8 Sensory: 2
9 Best Language: 2
10 Dysarthria: 1
11 Neglect: 1
Total NIHSS: [15+]
,Rationale: This patient presents with a severe right hemispheric stroke
characterized by left-sided paralysis (5b=4, 6b=4), significant visual loss
(3=2), severe sensory loss (8=2), and severe aphasia (9=2). The patient
is alert (1a=0) but answers neither LOC question correctly (1b=2) and
performs only one command (1c=1). This pattern is consistent with a large
cortical infarct affecting multiple motor and sensory pathways .
Patient 2 - Mild Motor & Sensory Deficit
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: 1
9 Best Language: 0
10 Dysarthria: 0
11 Neglect: 0
Total NIHSS: [4]
, Rationale: This patient demonstrates mild left leg drift (6a=1) and some
effort against gravity in the left leg (6b=2), along with mild-to-moderate
sensory loss (8=1). No facial palsy, aphasia, or neglect is present. This
represents a mild focal deficit stroke with primarily motor and sensory
involvement .
Patient 3 - Moderate Focal Deficit
Scores
1a LOC: 0
1b LOC Questions: 0
1c LOC Commands: 0
2 Best Gaze: 0
3 Visual Fields: 0
4 Facial Palsy: 1
5 Motor Arms (L/R):
6 Motor Legs (L/R):
7 Limb Ataxia: 1
8 Sensory: 1
9 Best Language: 0
10 Dysarthria: 0
11 Neglect: 0
Total NIHSS: [4]
