01 1a. Level of consciousness 0 Alert — responds appropriately 1 Drowsy — arousable with minimal stimulation 2 Stuporous — requires repeated or painful stimulation 3 Coma — reflex responses or no response
02 1b. Verbal questions Ask the month and the patient's age. Do not help with gestures.
0 Answers both questions correctly 1 Answers one question correctly 2 Does not answer either correctly
03 1c. Motor commands Instruct to open/close eyes and make a fist/open the non-paretic hand.
0 Performs both commands correctly 1 Performs one command correctly 2 Performs neither command
04 2. Conjugate gaze Only voluntary or reflex horizontal eye movements (oculocephalic).
0 Normal 1 Partial palsy — deviation or palsy but not forced 2 Forced deviation — total palsy not overcomeable
05 3. Visual fields Visual confrontation in each quadrant. If unilateral blindness, score the healthy eye field.
0 No visual loss 1 Partial hemianopia 2 Complete hemianopia 3 Bilateral hemianopia / cortical blindness
06 4. Facial palsy 0 Normal — symmetrical movements 1 Minor palsy — asymmetry on smile, flattened nasolabial fold 2 Partial palsy — complete paralysis of lower hemiface 3 Complete paralysis — upper and lower
07 5a. Right upper extremity Maintain arm extended at 90° (sitting) or 45° (supine) for 10 s. Record N/A if amputation or other cause.
0 No drift — holds position 10 s 1 Drift — drifts before 10 s, does not hit bed 2 Some effort against gravity — drifts to bed 3 No effort against gravity — falls, can move 4 No movement N/A N/A — amputation or arthrodesis
08 5b. Left upper extremity 0 No drift — holds position 10 s 1 Drift — drifts before 10 s, does not hit bed 2 Some effort against gravity — drifts to bed 3 No effort against gravity — falls, can move 4 No movement N/A N/A — amputation or arthrodesis
09 6a. Right lower extremity Maintain leg extended at 30° supine for 5 s. Record N/A if amputation or other cause.
0 No drift — holds position 5 s 1 Drift — drifts before 5 s, does not hit bed 2 Some effort against gravity — drifts to bed 3 No effort against gravity — falls, can move 4 No movement N/A N/A — amputation or arthrodesis
10 6b. Left lower extremity 0 No drift — holds position 5 s 1 Drift — drifts before 5 s, does not hit bed 2 Some effort against gravity — drifts to bed 3 No effort against gravity — falls, can move 4 No movement N/A N/A — amputation or arthrodesis
11 7. Limb ataxia Finger-nose and heel-shin test. Score only if disproportionate to paresis.
0 Absent 1 Present in one limb 2 Present in two limbs
12 8. Sensory Evaluate with pin. Only severe defect or hemihypesthesia scorable if altered consciousness.
0 Normal — no sensory loss 1 Mild-moderate — hypesthesia, but aware of touch 2 Severe or total — does not recognize touch in face, arm and leg
13 9. Language / Aphasia Description of picture, object naming and reading standard sentences.
0 Normal — no aphasia 1 Mild-moderate aphasia — communication possible with difficulty 2 Severe aphasia — fragmented communication 3 Mutism / global aphasia
14 10. Dysarthria Read or repeat words from the standard list. Record N/A if intubated or other cause.
0 Normal 1 Mild-moderate — speaks with difficulty but understandable 2 Severe — speech unintelligible or anarthria N/A N/A — intubated or other cause
15 11. Extinction / Neglect Simultaneous bilateral stimulation. Also evaluate visual and spatial neglect.
0 No abnormality 1 Inattention or extinction in one modality 2 Profound hemi-inattention in more than one modality