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NIH Stroke Scale (NIHSS)

Written by the Elysia Tools team · Last updated：2026-08-07

This tool is for informational purposes only and does not constitute medical, financial, or legal advice; consult a qualified professional for advice.

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.

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Key facts

Category
Health
Input types
select
Output type
json
Sample coverage
4
API ready
Yes

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.

When to use

  • When a trained clinician needs a structured NIHSS score during an acute stroke assessment.

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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

    1. 1Select the observed finding for each of the 15 NIHSS items, including separate left and right arm and leg motor scores.
    2. 2The calculator adds the item scores to produce the standard NIHSS total from 0 to 42.
    3. 3It also identifies the more affected side using the left and right limb motor findings.
    4. 4The 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.

    Examples

    1. Right MCA syndrome with moderate-to-severe deficit

    Stroke team clinician

    Background

    A patient presents with drowsiness, forced left gaze, complete left hemianopia, facial palsy, right-sided weakness, mild sensory loss, dysarthria, and partial neglect.

    Problem

    Calculate the NIHSS total and classify the severity of the neurological deficit.

    How to use

    Select the documented findings for consciousness, gaze, vision, facial palsy, right arm and leg weakness, sensation, dysarthria, and neglect; leave unaffected items at 0.

    LOC 1; LOC questions 1; LOC commands 1; gaze 2; visual fields 2; facial palsy 2; left arm 0; right arm 2; left leg 0; right leg 2; ataxia 0; sensory 1; language 0; dysarthria 1; extinction/inattention 1.

    Outcome

    The calculator returns an NIHSS total of 16, classified as moderate-to-severe stroke, with the right side more affected.

    2. Minor stroke with limited motor and sensory findings

    Neurology trainee

    Background

    A patient is alert and oriented but has minor facial palsy, slight right arm drift, mild sensory loss, and partial inattention.

    Problem

    Produce a standardized score for a mild neurological deficit.

    How to use

    Enter 1 for facial palsy, right arm motor, sensory, and extinction/inattention, and select 0 for all other items.

    LOC 0; LOC questions 0; LOC commands 0; gaze 0; visual fields 0; facial palsy 1; left arm 0; right arm 1; left leg 0; right leg 0; ataxia 0; sensory 1; language 0; dysarthria 0; extinction/inattention 1.

    Outcome

    The calculator returns an NIHSS total of 4, classified as a minor stroke.

    FAQ

    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.

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