# NIH Stroke Scale (NIHSS) Calculate the NIH Stroke Scale (NIHSS) to quantify acute stroke neurologic deficit across 11 categories (15 scored items, with left & right limb motor graded separately). Items: 1a Level of consciousness (0–3), 1b LOC questions (0–2), 1c LOC commands (0–2), 2 Best gaze (0–2), 3 Visual fields (0–3), 4 Facial palsy (0–3), 5a/5b Motor arm left/right (0–4 each), 6a/6b Motor leg left/right (0–4 each), 7 Limb ataxia (0–2), 8 Sensory (0–2), 9 Best language (0–3), 10 Dysarthria (0–2), 11 Extinction/inattention (0–2). Both left and right limb motor scores are summed into the total (standard NIHSS); the tool also reports the more-affected side (max of left/right) for clinical context. Range 0–42; higher = more severe. Interpretation: 0 no symptoms, 1–4 minor, 5–15 moderate, 16–20 moderate-to-severe, 21–42 severe. Derived from Brott et al. 1989 (Stroke) and NINDS instructions. Scoring reliability is examiner-dependent and should be performed by trained personnel. Not medical advice. > Canonical page: https://elysiatools.com/en/tools/nihss-score - **Category:** Health - **Keywords:** NIHSS, NIH Stroke Scale, stroke, CVA, cerebrovascular, neurology, deficit, thrombolysis, infarction, hemorrhage ## Overview The NIH Stroke Scale (NIHSS) calculator scores acute stroke-related neurological deficits across 15 items in 11 categories. Enter the examiner's findings to calculate a total from 0 to 42, view the severity range, and identify the more affected side for clinical context. ## Inputs - **1a Level of consciousness** (select): 0 = alert; 3 = unresponsive. - **1b LOC questions** (select): Ask the month and the patient's age. 0 = both correct; 2 = neither correct. - **1c LOC commands** (select): Open/close eyes and grip/non-grip hand. 0 = both correct; 2 = neither. - **2 Best gaze** (select): Test horizontal eye movement. 0 = normal; 2 = forced deviation / total paresis. - **3 Visual fields** (select): Confrontation testing. 0 = no loss; 3 = bilateral hemianopia / blind. - **4 Facial palsy** (select): 0 = normal symmetry; 3 = complete unilateral/bilateral paralysis. - **5a Motor arm — left** (select): Drift test, left arm. 0 = no drift; 4 = no movement. - **5b Motor arm — right** (select): Drift test, right arm. 0 = no drift; 4 = no movement. - **6a Motor leg — left** (select): Drift test, left leg. 0 = no drift; 4 = no movement. - **6b Motor leg — right** (select): Drift test, right leg. 0 = no drift; 4 = no movement. - **7 Limb ataxia** (select): Finger-nose / heel-shin. 0 = absent; 2 = present in two limbs. - **8 Sensory** (select): Pinprick on face, arm, trunk, leg. 0 = normal; 2 = severe-to-total loss. - **9 Best language** (select): Naming, read list, describe picture. 0 = no aphasia; 3 = mute / global aphasia. - **10 Dysarthria** (select): Read/repeat words. 0 = normal articulation; 2 = severe/unintelligible or mute. - **11 Extinction / inattention** (select): Double simultaneous stimulation. 0 = no neglect; 2 = complete neglect (two modalities). ## When to use - When a trained clinician needs a structured NIHSS score during an acute stroke assessment. - When documenting neurological deficits across consciousness, gaze, vision, motor function, sensation, language, and attention. - When comparing standardized stroke severity scores during clinical evaluation or follow-up. ## How it works - Select the observed finding for each of the 15 NIHSS items, including separate left and right arm and leg motor scores. - The calculator adds the item scores to produce the standard NIHSS total from 0 to 42. - It also identifies the more affected side using the left and right limb motor findings. - The result includes an interpretation: no symptoms, minor, moderate, moderate-to-severe, or severe stroke. ## Use cases - Emergency stroke assessment and standardized neurological documentation. - Neurology training using representative NIHSS examination findings. - Clinical review of motor, sensory, language, visual, and attention deficits. ## Frequently asked questions ### What does the NIHSS calculator measure? It quantifies neurological deficit in acute stroke using 15 scored items across 11 categories. ### What is the NIHSS score range? The total ranges from 0 to 42, with higher scores indicating more severe neurological impairment. ### How is the NIHSS score interpreted? A score of 0 indicates no symptoms; 1–4 is minor, 5–15 moderate, 16–20 moderate-to-severe, and 21–42 severe. ### Are left and right limb scores both included? Yes. Left and right arm and leg motor findings are scored separately and included in the standard total. ### Who should use this calculator? NIHSS scoring should be performed by trained personnel because scoring reliability depends on examiner training and technique. ## Related tools - [Data Boundary Processor](https://elysiatools.com/en/tools/data-boundary-processor): Advanced boundary value processing tool that identifies and handles minimum/maximum values in numerical data. Perfect for data validation, range checking, statistical analysis, and data preprocessing. 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