UMEM Educational Pearls

Category: Neurology

Title: Scoring Part 1C (LOC) of NIH Stroke Scale

Keywords: nihss, level of consciousness, stroke, nih stroke scale (PubMed Search)

Posted: 4/2/2009 by Aisha Liferidge, MD (Updated: 3/29/2024)
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  • With regard to following commands, the NIH Stroke Scale (NIHSS) assesses this level of consciousness in part 1C by asking the patient to do the following two things:

          1.  "Close your eyes and now open them."

          2.  "Make a fist and now open it."

  • You may repeat the command no more than twice in order to avoid the bias of coaching the patient.
  • It's fine to provide some prompting by performing the task yourself while asking the patient to do the same.
     
  • This component of the NIHSS is scored as follows:

          0 = performs both tasks correctly.
          1 = performs one task corectly.
          2 = performs neither task correctly.