NIH Stroke Scale Group B
Patient
Scenario 1: Level of Consciousness & Orientation
Patient Presentation:
The patient is awake but confused. When asked, "What month is it?" they respond
incorrectly. When asked, "How old are you?" they give the correct age.
Question 1:
How would you score the Level of Consciousness Questions (LOCQ) section?
Answer:
Month: Incorrect → 1 point
Age: Correct → 0 points
Total LOCQ Score: 1
Scenario 2: Commands
Patient Presentation:
You ask the patient to open and close their eyes, and then make a fist and let go.
,They open and close their eyes correctly.
They cannot make a fist, despite being prompted multiple times.
Question 2:
What is the score for LOC Commands?
Answer:
First command correct → 0
Second command incorrect → 1
Total LOC Commands Score: 1
Scenario 3: Best Gaze
Patient Presentation:
The patient’s eyes deviate slightly to the right but can move past midline when
prompted.
Question 3:
What is the correct Best Gaze score?
Answer:
Partial gaze palsy present but can move past midline → 1
Scenario 4: Visual Fields
Patient Presentation:
When testing visual fields, the patient cannot see fingers in the left visual field of
both eyes, indicating complete hemianopia.
,Question 4:
How should you score Visual Fields?
Answer:
Complete hemianopia → 2
Scenario 5: Facial Palsy
Patient Presentation:
When asked to smile, raise eyebrows, and close eyes tightly:
Forehead movement is normal.
Mild asymmetry in mouth corner when smiling.
Question 5:
What is the Facial Palsy score?
Answer:
Minor facial weakness → 1
Scenario 6: Motor Arm (Left)
Patient Presentation:
When asked to hold their left arm out at 90 degrees:
The arm drifts but does not hit the bed within 10 seconds.
Question 6:
, Score the Left Arm Motor Function.
Answer:
Drift but does not hit the bed → 1
Scenario 7: Motor Arm (Right)
Patient Presentation:
When asked to hold their right arm out at 90 degrees:
The arm immediately falls to the bed.
Question 7:
Score the Right Arm Motor Function.
Answer:
No effort against gravity → 3
Scenario 8: Motor Leg (Left)
Patient Presentation:
When asked to lift the left leg to 30 degrees:
The leg drifts to the bed after 3 seconds.
Question 8:
Score the Left Leg Motor Function.
Answer:
Patient
Scenario 1: Level of Consciousness & Orientation
Patient Presentation:
The patient is awake but confused. When asked, "What month is it?" they respond
incorrectly. When asked, "How old are you?" they give the correct age.
Question 1:
How would you score the Level of Consciousness Questions (LOCQ) section?
Answer:
Month: Incorrect → 1 point
Age: Correct → 0 points
Total LOCQ Score: 1
Scenario 2: Commands
Patient Presentation:
You ask the patient to open and close their eyes, and then make a fist and let go.
,They open and close their eyes correctly.
They cannot make a fist, despite being prompted multiple times.
Question 2:
What is the score for LOC Commands?
Answer:
First command correct → 0
Second command incorrect → 1
Total LOC Commands Score: 1
Scenario 3: Best Gaze
Patient Presentation:
The patient’s eyes deviate slightly to the right but can move past midline when
prompted.
Question 3:
What is the correct Best Gaze score?
Answer:
Partial gaze palsy present but can move past midline → 1
Scenario 4: Visual Fields
Patient Presentation:
When testing visual fields, the patient cannot see fingers in the left visual field of
both eyes, indicating complete hemianopia.
,Question 4:
How should you score Visual Fields?
Answer:
Complete hemianopia → 2
Scenario 5: Facial Palsy
Patient Presentation:
When asked to smile, raise eyebrows, and close eyes tightly:
Forehead movement is normal.
Mild asymmetry in mouth corner when smiling.
Question 5:
What is the Facial Palsy score?
Answer:
Minor facial weakness → 1
Scenario 6: Motor Arm (Left)
Patient Presentation:
When asked to hold their left arm out at 90 degrees:
The arm drifts but does not hit the bed within 10 seconds.
Question 6:
, Score the Left Arm Motor Function.
Answer:
Drift but does not hit the bed → 1
Scenario 7: Motor Arm (Right)
Patient Presentation:
When asked to hold their right arm out at 90 degrees:
The arm immediately falls to the bed.
Question 7:
Score the Right Arm Motor Function.
Answer:
No effort against gravity → 3
Scenario 8: Motor Leg (Left)
Patient Presentation:
When asked to lift the left leg to 30 degrees:
The leg drifts to the bed after 3 seconds.
Question 8:
Score the Left Leg Motor Function.
Answer:
