NIHSS Dysarthria Assessment 5

Question 1

A patient scores 0 on NIHSS best language (item 9) but 1 on dysarthria (item 10). What does this combination indicate?

Accepted Answer

The patient has intact language content but impaired motor articulation

Answer

Normal language with mild dysarthria indicates intact linguistic processing but disrupted corticobulbar or cerebellar motor speech pathways.

Question 2

A patient has facial droop (NIHSS item 4 = 2) but no dysarthria. This is best explained by:

Accepted Answer

Bilateral facial innervation fully compensates for unilateral droop during speech

Answer

The lower face has predominantly contralateral cortical innervation, but the muscles critical for speech receive enough bilateral cortical input to maintain intelligibility despite unilateral droop.

Question 3

In the context of the NIHSS, 'mild to moderate dysarthria' (score 1) is defined as speech that is:

Accepted Answer

Slurred but the patient can be understood

Answer

NIHSS score 1 for dysarthria is explicitly defined as slurred but understandable speech — the patient is intelligible though articulation is abnormal.

Question 4

Which scenario represents correct NIHSS dysarthria scoring after tPA administration?

Accepted Answer

Dysarthria is re-scored at 2 hours and 24 hours as part of serial NIHSS assessment

Answer

Serial NIHSS assessments at 2 and 24 hours post-tPA include all items including dysarthria to track treatment response and detect complications.

Question 5

A patient with known Parkinson's disease has hypophonic, mildly slurred speech at baseline. During acute stroke workup, the NIHSS dysarthria score should reflect:

Accepted Answer

Score based on the acute change from the patient's documented Parkinson's baseline

Answer

NIHSS measures acute neurological change; if a Parkinson's baseline is known, the examiner scores the acute increment beyond that baseline.

NIHSS - National Institutes of Health Stroke Scale Practice Test

NIHSS - National Institutes of Health Stroke Scale Practice Test

NIHSS Dysarthria Assessment 5