NIHSS Facial Palsy 2

Question 1

A patient grimaces asymmetrically when the clinician applies a noxious stimulus. The lower face droops on the left while the upper face appears symmetric. What NIHSS Facial Palsy score is most appropriate?

Accepted Answer

2 – Partial paralysis

Answer

Partial paralysis (score 2) describes complete or near-complete lower facial paresis with the upper face relatively spared.

Question 2

Which cranial nerve is specifically assessed when scoring Facial Palsy on the NIHSS?

Accepted Answer

CN VII (Facial)

Answer

The NIHSS Facial Palsy item evaluates the function of cranial nerve VII, the facial nerve.

Question 3

An unresponsive intubated patient cannot follow commands. How should the examiner assess facial symmetry for NIHSS item 4?

Accepted Answer

Apply noxious stimuli and observe facial grimacing symmetry

Answer

In unresponsive patients, noxious stimulation elicits a grimace response that allows assessment of facial symmetry.

Question 4

A score of 3 on the NIHSS Facial Palsy item indicates:

Accepted Answer

Complete palsy with no movement on one or both sides of the face

Answer

A score of 3 represents complete unilateral or bilateral facial paralysis with absence of movement.

Question 5

A patient with a right MCA stroke has left lower facial droop but closes both eyes symmetrically against resistance. Which NIHSS Facial Palsy score applies?

Accepted Answer

2

Answer

Preserved eye closure with lower facial paresis is characteristic of partial (central) palsy, scored as 2.

NIHSS - National Institutes of Health Stroke Scale Practice Test

NIHSS - National Institutes of Health Stroke Scale Practice Test

NIHSS Facial Palsy 2