NIHSS Limb Ataxia 5

Question 1

A patient presents with acute vertigo, ipsilateral facial numbness, and right arm ataxia after a lateral medullary infarct. What NIHSS limb ataxia score would be expected?

Accepted Answer

1

Answer

Wallenberg (lateral medullary) syndrome typically causes ipsilateral limb ataxia in one limb, scoring 1.

Question 2

Which of the following patient presentations is MOST consistent with an NIHSS limb ataxia score of 0?

Accepted Answer

Patient with a pure motor lacunar infarct and no coordination deficits on testing

Answer

A pure motor lacunar infarct involves the corticospinal tract, not the cerebellum, so coordination testing would be normal (score 0).

Question 3

In a patient with intact strength but significant intention tremor during finger-nose-finger testing, what NIHSS limb ataxia score applies?

Accepted Answer

1 — ataxia present in one limb

Answer

Intention tremor during the finger-nose-finger test in the presence of normal strength reflects cerebellar ataxia and scores 1 for that limb.

Question 4

A patient's NIHSS is being administered remotely via telemedicine. The patient is asked to perform finger-nose-finger testing on camera. Which statement about scoring limb ataxia is most accurate?

Accepted Answer

Limb ataxia can be scored if the examiner can clearly observe the movement on camera

Answer

Telemedicine NIHSS can include limb ataxia assessment when camera quality allows clear visualization of the movement.

Question 5

A patient performs heel-to-shin testing with the right leg smoothly but shows gross dysmetria with the left leg despite only mild left leg weakness (4/5). What is the limb ataxia score?

Accepted Answer

1

Answer

Left leg dysmetria is clearly out of proportion to the mild (4/5) weakness, confirming ataxia in one limb — score 1.

NIHSS - National Institutes of Health Stroke Scale Practice Test

NIHSS - National Institutes of Health Stroke Scale Practice Test

NIHSS Limb Ataxia 5