NIHSS Facial Palsy 4

Question 1

When should the NIHSS Facial Palsy item be reassessed after the initial stroke evaluation?

Accepted Answer

At each serial NIHSS assessment per institutional and trial protocol

Answer

Serial NIHSS assessments, including Facial Palsy, are performed at each reassessment interval defined by institutional or clinical trial protocol.

Question 2

A patient with a prior right-sided Bell's palsy presents with a new left MCA stroke and shows left lower facial droop. How should the examiner approach NIHSS Facial Palsy scoring?

Accepted Answer

Score only the new left-sided weakness; document the old right-sided palsy separately

Answer

The NIHSS scores deficits attributable to the acute stroke; the prior Bell's palsy on the right is documented but does not affect scoring of new left-sided findings.

Question 3

For a patient who is aphasic and cannot follow verbal commands, which technique best evaluates Facial Palsy on the NIHSS?

Accepted Answer

Use demonstration gestures and pantomime to elicit facial movement

Answer

Gestural demonstration or pantomime can elicit volitional facial movement in aphasic patients who cannot respond to verbal instructions.

Question 4

Which cerebral artery territory infarct most commonly produces an NIHSS Facial Palsy score of 2 with sparing of the forehead?

Accepted Answer

Middle cerebral artery (MCA)

Answer

MCA territory infarcts affecting the facial motor cortex or corticobulbar tracts classically produce contralateral lower facial (central) palsy with forehead sparing.

Question 5

A patient scores 2 on Facial Palsy at baseline. After thrombolysis, the repeat NIHSS shows both nasolabial folds are symmetric and the patient smiles symmetrically. What is the new score?

Accepted Answer

0 – normal symmetric facial movement

Answer

If facial movements are now symmetric and normal, the correct score is 0 regardless of the prior finding.

NIHSS - National Institutes of Health Stroke Scale Practice Test

NIHSS - National Institutes of Health Stroke Scale Practice Test

NIHSS Facial Palsy 4