APEX NIH Stroke Scale GROUP E (V5) - 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 E1
Total Score: 0
Severity: No Stroke Symptoms
Dominant Deficit Pattern: Completely normal neurologic examination. All
NIHSS domains are fully intact.
Item Domain Score Clinical Description
1a LOC 0 Fully alert.
1b LOC Questions 0 Answers both 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 0 Normal symmetrical movement.
5a Motor Arm (Left) 0 No drift; normal strength.
5b Motor Arm (Right) 0 No drift; normal strength.
6a Motor Leg (Left) 0 No drift; normal strength.
6b Motor Leg (Right) 0 No drift; normal strength.
7 Limb Ataxia 0 No ataxia.
8 Sensory 0 Normal sensation.
pg. 1
, 9 Best Language 0 No aphasia.
10 Dysarthria 0 Normal articulation.
11 Extinction/Neglect 0 No neglect or inattention.
Patient E2
Total Score: 10
Severity: Moderate Stroke
Dominant Deficit Pattern: Dense right hemiplegia (arm flaccid, leg severely
weak) with mild aphasia, mild facial palsy, and mild sensory loss.
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 4 Critical: No movement at all (flaccid).
(Right)
6a Motor Leg (Left) 0 No drift; normal strength.
6b Motor Leg (Right) 3 Significant: No effort against gravity; falls
immediately.
7 Limb Ataxia 0 No ataxia.
8 Sensory 1 Mild-to-moderate sensory loss.
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 E1
Total Score: 0
Severity: No Stroke Symptoms
Dominant Deficit Pattern: Completely normal neurologic examination. All
NIHSS domains are fully intact.
Item Domain Score Clinical Description
1a LOC 0 Fully alert.
1b LOC Questions 0 Answers both 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 0 Normal symmetrical movement.
5a Motor Arm (Left) 0 No drift; normal strength.
5b Motor Arm (Right) 0 No drift; normal strength.
6a Motor Leg (Left) 0 No drift; normal strength.
6b Motor Leg (Right) 0 No drift; normal strength.
7 Limb Ataxia 0 No ataxia.
8 Sensory 0 Normal sensation.
pg. 1
, 9 Best Language 0 No aphasia.
10 Dysarthria 0 Normal articulation.
11 Extinction/Neglect 0 No neglect or inattention.
Patient E2
Total Score: 10
Severity: Moderate Stroke
Dominant Deficit Pattern: Dense right hemiplegia (arm flaccid, leg severely
weak) with mild aphasia, mild facial palsy, and mild sensory loss.
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 4 Critical: No movement at all (flaccid).
(Right)
6a Motor Leg (Left) 0 No drift; normal strength.
6b Motor Leg (Right) 3 Significant: No effort against gravity; falls
immediately.
7 Limb Ataxia 0 No ataxia.
8 Sensory 1 Mild-to-moderate sensory loss.
pg. 2
