NATIONAL INSTITUTES OF HEALTH
Stroke Scale
CATEGORY STROKE SCALE SCORE
1a. Level of consciousness 0 1 2 3
Alert, Drowsy, etc Alert Drowsy Stuporous Coma
1b. LOC Questions 0 1 2
Month, age Answers both Answers one Incorrect
correctly correctly
1c. LOC Commands 0 1 2
Open/close eyes, make a fist & let go Obeys both Obeys one Incorrect
correctly correctly
2. Best Gaze
0 1 2
Eyes open - pt follows examiner’s
Normal Partial gaze Forced
fingers or face. palsy deviation
3. Visual
0 1 2 3
Introduce visual stimulus/threat to pt’s visual
field quadrants. Cover 1 eye and hold up No visual Partial Complete Bilateral
loss hemianopsia hemianopsia hemianopsia
fingers in all 4 quadrants.
4. Facial Palsy 0 1 2 3
Show teeth, raise eyebrows and squeeze
Normal Minor Partial Complete
eyes tightly shut.
5.a Motor Arm - Left 0 1 2 3 4
Elevate extremity to 90 degrees and score No Drift Drift Can’t resist No effort No
drift/movement. Count to 10 out loud and use gravity against gravity Movement
fingers for visual cue. NT = Amputation, joint fusion
5.b Motor Arm - Right 0 1 2 3 4
Elevate extremity to 90 degrees and score No Drift Drift Can’t resist No effort No
gravity against gravity Movement
drift/movement. Count to 10 out loud and use
fingers for visual cue. NT = Amputation, joint fusion
TOTAL =
6.a Motor Leg - Left 0 1 2 3 4
Elevate extremity to 30 degrees and score No Drift Drift Can’t resist No effort No
drift/movement. Count to 5 out loud and use gravity against gravity Movement
fingers for visual cue. NT = Amputation, joint fusion
6.b Motor Leg - Right 0 1 2 3 4
Elevate extremity to 30 degrees and score No Drift Drift Can’t resist No effort No
drift/movement. Count to 5 out loud and use gravity against gravity Movement
fingers for visual cue. NT = Amputation, joint fusion
7. Limb Ataxia 0 1 2
Finger to nose, heal down shin Absent Present in Present in
one limb two limbs
8. Sensory
0 1 2
Pin prick to face, arms, trunk, and legs -
Normal Partial loss Severe Loss
compare sharpness side to side
9. Best Language
Name items, describe picture, and read
0 1 2 3
sentences. Don’t forget glasses if they No aphasia Mild to Severe Mute
moderate aphasia
normally wear them. aphasia
10. Dysarthria 0 1 2
Normal Mild to Near to
Evaluate speech clarity by pt reading or articulation moderate unintelligible
dysarthria or worse
repeating words on list.
NT = Intubated or other physical barrier
11. Extinction and Inattention
Use information from prior testing or double 0 1 2
simultaneous stimuli testing to identify No neglect Partial Complete
neglect neglect
neglect. Face, arms, legs, and visual fields.
NT = Not Testable acceptable as noted above
Score Stroke Severity
0 No stroke symptoms
1-4
5-15
Minor stroke
Moderate stroke
TOTAL =
16-20 Moderate to severe stroke
21-42 Severe stroke
