NIHSS Best Gaze 2

Question 1

A patient with acute stroke has gaze that is abnormal in one eye but the other eye moves normally. There is no forced deviation. What is the NIHSS Best Gaze score?

Accepted Answer

1

Answer

A score of 1 (partial gaze palsy) is assigned when gaze is abnormal in one or both eyes without forced deviation or total gaze paresis.

Question 2

Which eye movements are specifically tested in the NIHSS Best Gaze item?

Accepted Answer

Horizontal eye movements only

Answer

The NIHSS Best Gaze item tests only horizontal eye movements, not vertical gaze.

Question 3

A stroke patient has a forced eye deviation to the right that cannot be overcome by the oculocephalic maneuver. What is the Best Gaze score?

Accepted Answer

2

Answer

Forced deviation or total gaze paresis not overcome by the oculocephalic maneuver scores a 2.

Question 4

When is the oculocephalic maneuver (doll's eye) permitted in NIHSS Best Gaze testing?

Accepted Answer

Only in unconscious or uncooperative patients

Answer

The oculocephalic maneuver may be used for patients who are unconscious or otherwise unable to follow the voluntary gaze task.

Question 5

A patient following an acute stroke has a conjugate gaze deviation toward the right side and cannot move their eyes past midline to the left. The oculocephalic maneuver fails to correct this. What score is assigned?

Accepted Answer

2

Answer

Total gaze paresis with failed oculocephalic override = score 2, the maximum for Best Gaze.

NIHSS - National Institutes of Health Stroke Scale Practice Test

NIHSS - National Institutes of Health Stroke Scale Practice Test

NIHSS Best Gaze 2