NIHSS Limb Ataxia 2

Question 1

A patient with a right-hemisphere stroke can extend both arms but shows marked tremor and dysmetria only in the left arm. How is limb ataxia scored?

Accepted Answer

1 — ataxia in one limb

Answer

Ataxia is present in one limb (left arm), so the score is 1.

Question 2

Which cerebellar pathway is most commonly implicated when limb ataxia is detected on the NIHSS after an acute ischemic stroke?

Accepted Answer

Spinocerebellar tract via the posterior inferior cerebellar artery territory

Answer

The posterior inferior cerebellar artery (PICA) territory supplies the spinocerebellar pathways, and infarcts there frequently cause limb ataxia.

Question 3

An examiner asks a hemiplegic patient to perform heel-to-shin testing on the paretic leg. The patient cannot lift the leg at all. What is the correct score?

Accepted Answer

UN — untestable

Answer

When weakness prevents performance of the task, the item is scored UN (untestable) and ataxia cannot be attributed.

Question 4

Limb ataxia on the NIHSS is specifically designed to detect dysfunction of which neural structure?

Accepted Answer

Cerebellum and its pathways

Answer

The limb ataxia item isolates cerebellar dysfunction by testing coordination independent of weakness.

Question 5

A stroke patient scores 2 on the limb ataxia item. What does this indicate?

Accepted Answer

Ataxia present in two limbs

Answer

A score of 2 on the NIHSS limb ataxia item means ataxia is present in two limbs.

NIHSS - National Institutes of Health Stroke Scale Practice Test

NIHSS - National Institutes of Health Stroke Scale Practice Test

NIHSS Limb Ataxia 2