NIHSS Limb Ataxia 3

Question 1

A patient with a left PICA infarct demonstrates ataxia in both the left arm and left leg during NIHSS testing. How should the limb ataxia item be scored?

Accepted Answer

2

Answer

Ataxia in two limbs (ipsilateral arm and leg) yields a score of 2.

Question 2

Why does the NIHSS instruct examiners to score limb ataxia only in proportion to weakness?

Accepted Answer

Because weakness alone can mimic ataxia and must be distinguished

Answer

Weakness can prevent smooth movement and falsely appear as ataxia, so the NIHSS requires that coordination deficits be out of proportion to motor deficits to count.

Question 3

Which test is used to evaluate lower-limb ataxia in a supine stroke patient during NIHSS assessment?

Accepted Answer

Heel-to-shin test

Answer

The heel-to-shin test is the standard NIHSS maneuver for assessing lower-limb coordination in bed-bound patients.

Question 4

A patient with a brainstem stroke has bilateral upper-limb ataxia but intact lower-limb coordination. What is the limb ataxia score?

Accepted Answer

2

Answer

Both upper limbs are ataxic (two limbs total), yielding a score of 2.

Question 5

An aphasic patient cannot follow verbal commands for finger-nose-finger testing. The examiner uses a visual demonstration. The patient still cannot perform the task due to apparent confusion. How is limb ataxia recorded?

Accepted Answer

UN — untestable

Answer

If ataxia cannot be assessed due to cognitive or communication barriers preventing task performance, the item is scored UN.

NIHSS - National Institutes of Health Stroke Scale Practice Test

NIHSS - National Institutes of Health Stroke Scale Practice Test

NIHSS Limb Ataxia 3