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Neurology · Emergency Medicine

Modified NIH Stroke Scale calculator

Enter the published formula inputs below to calculate and interpret this score.

Clinical inputs

Month and age questions
Two simple commands
Horizontal gaze
Visual fields
Left arm, 10-second hold

Arms are held for 10 seconds. Untestable adds 0.

Right arm, 10-second hold

Arms are held for 10 seconds. Untestable adds 0.

Left leg, 5-second hold

Legs are held for 5 seconds. Untestable adds 0.

Right leg, 5-second hold

Legs are held for 5 seconds. Untestable adds 0.

Sensation
Language
Neglect

Result

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Clinical inputs

  • Month and age questions
  • Two simple commands
  • Horizontal gaze
  • Visual fields
  • Left arm, 10-second hold
  • Right arm, 10-second hold
  • Left leg, 5-second hold
  • Right leg, 5-second hold
  • Sensation
  • Language
  • Neglect

Primary source

Lyden PD et al. A modified National Institutes of Health Stroke Scale for use in stroke clinical trials. Stroke. DOI: 10.1161/01.STR.32.6.1310. PMID: 11387492. Level of consciousness, facial weakness, ataxia, and dysarthria are removed. Sensory is collapsed to normal 0 or abnormal 1. The remaining items keep the NIHSS grades and the worst total is 31. The item guide is printed in Meyer BC, Lyden PD. Int J Stroke. 2009. DOI: 10.1111/j.1747-4949.2009.00294.x. PMID: 19689755, Table 1: questions 0–2, commands 0–2, gaze 0–2, visual fields 0–3, each limb 0–4, language 0–3, neglect 0–2. Amputation or joint fusion is printed as UN and has no point, so it adds 0. (2001)

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