NIHSS Best Gaze 5

Question 1

A patient with acute stroke scores 2 on Best Gaze. Which statement about prognosis is most accurate based on this finding?

Accepted Answer

A score of 2 suggests severe stroke and is associated with worse outcomes

Answer

Higher NIHSS Best Gaze scores reflect more severe stroke and are associated with larger infarct volume and worse functional outcomes.

Question 2

Which phrase best describes 'forced deviation' as used in the NIHSS Best Gaze item?

Accepted Answer

Persistent tonic eye deviation that resists voluntary and reflex correction

Answer

Forced deviation is persistent conjugate deviation that resists voluntary effort and cannot be overcome by the oculocephalic reflex.

Question 3

A patient with basilar artery occlusion has bilateral eye deviation downward and inward ('ocular bobbing'). How is this captured on NIHSS Best Gaze?

Accepted Answer

Not captured — Best Gaze only tests horizontal movements

Answer

NIHSS Best Gaze tests only horizontal eye movements; vertical and other abnormal eye movements are not scored in this item.

Question 4

A nurse is rechecking NIHSS serially every 4 hours. On the second check, the patient's previously forced gaze deviation (score 2) is now partial (score 1). This change most likely indicates:

Accepted Answer

Improvement in the acute gaze deficit

Answer

A decrease in Best Gaze score from 2 to 1 during serial NIHSS monitoring reflects neurological improvement.

Question 5

Which of the following findings would score a 0 on NIHSS Best Gaze?

Accepted Answer

Full and symmetric horizontal gaze bilaterally

Answer

Normal (full, symmetric, conjugate) horizontal eye movements in both directions = score 0.

NIHSS - National Institutes of Health Stroke Scale Practice Test

NIHSS - National Institutes of Health Stroke Scale Practice Test

NIHSS Best Gaze 5