NIH Stroke Scale/Score (NIHSS)

The NIH Stroke Scale/Score (NIHSS) was developed through research supported by the NIH National Institute of Neurological Disorders and Stroke (NINDS) to help clinicians involved in the treatment of acute stroke judge the severity of a stroke. The NIH Stroke Scale is used by clinicians to measure neurological function and deficits by asking the person to answer questions and perform several physical and mental tests. A person's level of alertness, ability to communicate, and perform simple movements can be scored from the checklist of questions and tasks in the NIHSS tool. 

The NIH Stroke Scale/Score (NIHSS) comprises 15 questions covering the following 11 domains:

1. Level of consciousness
2. Best gaze
3. Visual  
4. Facial palsy
5. Motor arm
6. Motor leg
7. Limb ataxia
8. Sensory
9. Best language*
10. Dysarthria*
11. Extinction and Inattention

*Language (aphasia) and dysarthria testing media is embedded in the question.

Each answer is given a point value. The score is the sum of all points.

• Administer stroke scale items in the order listed.
• Do not go back and change scores.
• Score what you see, not what you think the patient can do.
• Do not coach the patient (i.e. repeated requests to patient to make a special effort)
• Score the first response, not the best response (except item 9, "Best Language")