NIHSS Extinction and Inattention 2

Question 1

A patient with a right hemisphere stroke ignores food on the left side of the tray and fails to respond to touch on the left arm when both arms are touched simultaneously. What NIHSS Item 11 score applies?

Accepted Answer

2 — profound hemi-inattention in more than one modality

Answer

Neglect involving more than one sensory modality (visual and tactile here) scores 2 on NIHSS Item 11.

Question 2

Which term best describes the phenomenon where a patient consistently fails to recognize or respond to stimuli on one side of space?

Accepted Answer

Hemispatial neglect

Answer

Hemispatial neglect is the clinical term for failing to attend to one side of space, assessed by NIHSS Item 11.

Question 3

During double simultaneous stimulation of the visual fields, the patient correctly identifies a finger wiggled on the right but consistently misses one wiggled on the left. The patient has no visual field cut on single presentation. This is:

Accepted Answer

Visual extinction; score 1

Answer

Extinction to double simultaneous visual stimulation with intact single-stimulus perception scores 1 on Item 11.

Question 4

A stroke patient can identify objects placed in either hand alone but when objects are placed in both hands simultaneously always identifies only the right-hand object. Which modality demonstrates extinction?

Accepted Answer

Tactile

Answer

Failure to perceive simultaneous tactile stimuli on one side while perceiving each side alone indicates tactile extinction.

Question 5

NIHSS Item 11 awards a score of 1 when:

Accepted Answer

Inattention or extinction is present in only one sensory modality

Answer

A score of 1 reflects mild neglect limited to a single modality such as visual or tactile extinction.

NIHSS - National Institutes of Health Stroke Scale Practice Test

NIHSS - National Institutes of Health Stroke Scale Practice Test

NIHSS Extinction and Inattention 2