NIHSS Stroke Scale Calculator

NIHSS Stroke Scale Calculator

Clinical assessment of neurological deficits

1a. Level of Consciousness
Assess responsiveness. 3 is scored only if patient makes no movement (except reflexes) to pain.
1b. LOC Questions
Ask: “What month is it?” and “What is your age?” Must be 100% correct. No credit for being close.
1c. LOC Commands
Ask patient to open/close eyes AND grip/release non-paretic hand. Pantomime if necessary.
2. Best Gaze
Test horizontal eye movement only. Follow finger or use oculocephalic reflex.
3. Visual Fields
Test by confrontation or visual threat. Score 3 if bilaterally blind.
4. Facial Palsy
Ask to show teeth, raise eyebrows, and close eyes tight.
5a. Left Arm Motor
Extend 90° (sitting) or 45° (supine). Score drift if it falls before 10 seconds.
5b. Right Arm Motor
6a. Left Leg Motor
Raise leg to 30° (supine). Score drift if it falls before 5 seconds.
6b. Right Leg Motor
7. Limb Ataxia
Finger-to-nose and heel-to-shin test. Score only if out of proportion to weakness.
8. Sensory
Pinprick testing. Score only stroke-related loss. Aphasic/coma score 0-1 or 2 respectively.
9. Best Language
Ask patient to describe a picture, name items, or read sentences.
10. Dysarthria
Listen to clarity of speech while patient reads or repeats words.
11. Extinction & Inattention
Test visual and tactile double simultaneous stimulation.
Total NIHSS Score 0
No Stroke Symptoms

This clinical assessment tool provides a standardized method for healthcare professionals to measure the severity of neurological deficits often observed in emergency settings. By evaluating specific domains—such as motor function, language capabilities, and sensory perception—medical teams can quickly quantify the level of impairment. This objective scoring system is vital for determining the appropriate course of treatment, monitoring the patient’s progress over time, and predicting long-term recovery outcomes.

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