modified_nih_stroke_scale: Modified NIH Stroke Scale (mNIHSS)

In cliot: Clinical Indices and Outcomes Tools

Modified NIH Stroke Scale (mNIHSS)

Description

Calculates the Modified NIH Stroke Scale (mNIHSS) score. This version of the NIHSS improves interrater reliability by removing items that are often difficult to score consistently, specifically Level of Consciousness (1A), Facial Palsy, Ataxia, and Dysarthria. It is validated for use in telemedicine and retrospective chart reviews.

Usage

modified_nih_stroke_scale(loc_questions, loc_commands, gaze, visual_fields,
                          motor_arm_left, motor_arm_right, motor_leg_left,
                          motor_leg_right, sensory, best_language,
                          extinction_inattention)

Arguments

loc_questions	Numeric (0-2). LOC Questions (Month and Age). 0: Answers both correctly. 1: Answers one correctly. 2: Answers neither correctly.
loc_commands	Numeric (0-2). LOC Commands (Open/close eyes, grip/release hand). 0: Performs both tasks correctly. 1: Performs one task correctly. 2: Performs neither task correctly.
gaze	Numeric (0-2). Best Gaze. 0: Normal. 1: Partial gaze palsy. 2: Forced deviation.
visual_fields	Numeric (0-3). Visual Fields. 0: No visual loss. 1: Partial hemianopia. 2: Complete hemianopia. 3: Bilateral hemianopia.
motor_arm_left	Numeric (0-4). Motor Arm (Left). 0: No drift. 1: Drift. 2: Some effort against gravity. 3: No effort against gravity. 4: No movement.
motor_arm_right	Numeric (0-4). Motor Arm (Right).
motor_leg_left	Numeric (0-4). Motor Leg (Left).
motor_leg_right	Numeric (0-4). Motor Leg (Right).
sensory	Numeric (0-2). Sensory. 0: Normal. 1: Mild-to-moderate sensory loss. 2: Severe to total sensory loss.
best_language	Numeric (0-3). Best Language. 0: No aphasia. 1: Mild-to-moderate aphasia. 2: Severe aphasia. 3: Mute, global aphasia.
extinction_inattention	Numeric (0-2). Extinction and Inattention (formerly Neglect). 0: No abnormality. 1: Visual, tactile, auditory, spatial, or personal inattention. 2: Profound hemi-inattention or extinction to more than one modality.

Value

A list containing:

mNIHSS_Score	The calculated total score (Range 0-31).
Severity	Interpretation of stroke severity (Minor, Moderate, Severe).

References

Meyer BC, Hemmen TM, Jackson CM, Lyden PD. Modified National Institutes of Health Stroke Scale for use in stroke clinical trials: reproducibility and validity. Stroke. 2002;33(5):1261-1266. doi:10.1161/01.str.0000015052.83017.8a

Examples

# Example 1: Moderate Stroke
# Incorrect age (1), Partial gaze (1), L-Arm drift (1), L-Leg drift (1), Mild aphasia (1)
modified_nih_stroke_scale(1, 0, 1, 0, 1, 0, 1, 0, 0, 1, 0)

# Example 2: Severe Stroke
# No commands (2), Forced gaze (2), Complete hemianopia (2),
# R-Arm/Leg paralysis (4, 4), Global aphasia (3), Neglect (2)
modified_nih_stroke_scale(0, 2, 2, 2, 0, 4, 0, 4, 0, 3, 2)

cliot documentation built on Dec. 1, 2025, 1:06 a.m.