Ask the patient to open and close their eyes, then to open and close the non-paretic hand (if the hand is not functional, another command should be performed).
Gaze
Only test horizontal eye movements.
Visual
Finger perimetry testing of all 4 quadrants.
Facial Palsy
Ask the patient to smile, then to close their eyes. If the command is not understood: use pantomime or look for symmetry of the grimace on painful stimulus.
Motor Function of the Right Arm
Hold the right arm for 10 seconds at 90 degrees sitting or 45 degrees lying.
Motor Function of the Left Arm
Hold the left arm for 10 seconds at 90 degrees sitting or 45 degrees lying.
Motor Function of the Right Leg
Hold the right leg for 5 seconds at 30 degrees lying.
Motor Function of the Left Leg
Hold the left leg for 5 seconds at 30 degrees lying.
Ataxia
Finger-nose test and heel-shin test bilaterally with eyes open. Do not test in case of incomplete wakefulness or plegia.
Sensory
Testing with a pin on the face, arm, trunk and leg. In case of reduced vigilance, test with a painful stimulus.
Text added:“<div class="relative"> <div class="absolute inset-0 flex items-center" aria-hidden="true"> <div class="w-full border-t border-gray-300"></div> </div> <div class="relative flex justify-center"> <span class="m-5 px-3 bg-white text-lg font-medium text-sky-600"> Facial Palsy </span> </div> </div> <span class="relative flex justify-center text-lg font-medium text-gray-900 m-3">Ask the patient to smile, then to close their eyes. If the command is not understood: use pantomime or look for symmetry of the grimace on painful stimulus.</span> <fieldset> <label class="rounded-tl-md rounded-tr-md relative border p-4 flex cursor-pointer focus:outline-none"><input type="radio" name="facial" x-on:click="facial = 0"> <div class="ml-3 flex flex-col"> <span class="block text-sm font-medium"> Normal symmetrical movement. <span class="text-sm font-bold">(0 points)</span></span> </div> </label> <label class="rounded-tl-md rounded-tr-md relative border p-4 flex cursor-pointer focus:outline-none"><input type="radio" name="facial" x-on:click="facial = 1"> <div class="ml-3 flex flex-col"> <span class="block text-sm font-medium"> Minor paresis: flattened nasolabial fold, asymmetry on smiling. <span class="text-sm font-bold">(1 point)</span></span> </div> </label> <label class="rounded-tl-md rounded-tr-md relative border p-4 flex cursor-pointer focus:outline-none"><input type="radio" name="facial" x-on:click="facial = 2"> <div class="ml-3 flex flex-col"> <span class="block text-sm font-medium"> Partial paresis, total or near-total paresis of the lower half of the face. <span class="text-sm font-bold">(2 points)</span></span> </div> </label> <label class="rounded-tl-md rounded-tr-md relative border p-4 flex cursor-pointer focus:outline-none"><input type="radio" name="facial" x-on:click="facial = 3"> <div class="ml-3 flex flex-col"> <span class="block text-sm font-medium"> Complete paralysis in the upper and lower half of the face. <span class="text-sm font-bold">(3 points)</span></span> </div> </label> </fieldset>”
Text added:“<div class="relative"> <div class="absolute inset-0 flex items-center" aria-hidden="true"> <div class="w-full border-t border-gray-300"></div> </div> <div class="relative flex justify-center"> <span class="m-5 px-3 bg-white text-lg font-medium text-sky-600"> Motor Function of the Right Arm </span> </div> </div> <span class="relative flex justify-center text-lg font-medium text-gray-900 m-3">Hold the right arm for 10 seconds at 90 degrees sitting or 45 degrees lying. </span>”
Text added:“<fieldset> <label class="rounded-tl-md rounded-tr-md relative border p-4 flex cursor-pointer focus:outline-none"><input type="radio" name="motorrightarm" x-on:click="motorrightarm = 0"> <div class="ml-3 flex flex-col"> <span class="block text-sm font-medium"> No drift within 10 seconds. <span class="text-sm font-bold">(0 points)</span> </span> </div> </label> <label class="rounded-tl-md rounded-tr-md relative border p-4 flex cursor-pointer focus:outline-none"><input type="radio" name="motorrightarm" x-on:click="motorrightarm = 1"> <div class="ml-3 flex flex-col"> <span class="block text-sm font-medium"> Drift after less than 10 seconds but without touching the supporting surface. <span class="text-sm font-bold">(1 point)</span> </span> </div> </label> <label class="rounded-tl-md rounded-tr-md relative border p-4 flex cursor-pointer focus:outline-none"><input type="radio" name="motorrightarm" x-on:click="motorrightarm = 2"> <div class="ml-3 flex flex-col"> <span class="block text-sm font-medium"> Patient can hold the arm but cannot fully extend it or the arm drifts and touches the supporting surface. <span class="text-sm font-bold">(2 points)</span> </span> </div> </label> <label class="rounded-tl-md rounded-tr-md relative border p-4 flex cursor-pointer focus:outline-none"><input type="radio" name="motorrightarm" x-on:click="motorrightarm = 3"> <div class="ml-3 flex flex-col"> <span class="block text-sm font-medium"> No effort against gravity. <span class="text-sm font-bold">(3 points)</span> </span> </div> </label> <label class="rounded-tl-md rounded-tr-md relative border p-4 flex cursor-pointer focus:outline-none"><input type="radio" name="motorrightarm" x-on:click="motorrightarm = 4"> <div class="ml-3 flex flex-col"> <span class="block text-sm font-medium"> No movement, plegia. <span class="text-sm font-bold">(4 points)</span> </span> </div> </label> <label class="rounded-tl-md rounded-tr-md relative border p-4 flex cursor-pointer focus:outline-none"><input type="radio" name="motorrightarm" x-on:click="motorrightarm = 0"> <div class="ml-3 flex flex-col"> <span class="block text-sm font-medium"> Not assessable, for example due to amputation. <span class="text-sm font-bold">(0 points)</span> </span> </div> </label> </fieldset>”
Text added:“<div class="relative"> <div class="absolute inset-0 flex items-center" aria-hidden="true"> <div class="w-full border-t border-gray-300"></div> </div> <div class="relative flex justify-center"> <span class="m-5 px-3 bg-white text-lg font-medium text-sky-600"> Motor Function of the Left Arm </span> </div> </div> <span class="relative flex justify-center text-lg font-medium text-gray-900 m-3">Hold the left arm for 10 seconds at 90 degrees sitting or 45 degrees lying. </span> <fieldset> <label class="rounded-tl-md rounded-tr-md relative border p-4 flex cursor-pointer focus:outline-none"><input type="radio" name="motorleftarm" x-on:click="motorleftarm = 0"> <div class="ml-3 flex flex-col"> <span class="block text-sm font-medium"> No drift within 10 seconds. <span class="text-sm font-bold">(0 points)</span> </span> </div> </label> <label class="rounded-tl-md rounded-tr-md relative border p-4 flex cursor-pointer focus:outline-none"><input type="radio" name="motorleftarm" x-on:click="motorleftarm = 1"> <div class="ml-3 flex flex-col"> <span class="block text-sm font-medium"> Drift after less than 10 seconds but without touching the supporting surface. <span class="text-sm font-bold">(1 point)</span> </span> </div> </label> <label class="rounded-tl-md rounded-tr-md relative border p-4 flex cursor-pointer focus:outline-none"><input type="radio" name="motorleftarm" x-on:click="motorleftarm = 2"> <div class="ml-3 flex flex-col"> <span class="block text-sm font-medium"> Patient can hold the arm but cannot fully extend it or the arm drifts and touches the supporting surface. <span class="text-sm font-bold">(2 points)</span> </span> </div> </label> <label class="rounded-tl-md rounded-tr-md relative border p-4 flex cursor-pointer focus:outline-none"><input type="radio" name="motorleftarm" x-on:click="motorleftarm = 3"> <div class="ml-3 flex flex-col"> <span class="block text-sm font-medium"> No effort against gravity. <span class="text-sm font-bold">(3 points)</span> </span> </div> </label> <label class="rounded-tl-md rounded-tr-md relative border p-4 flex cursor-pointer focus:outline-none"><input type="radio" name="motorleftarm" x-on:click="motorleftarm = 4"> <div class="ml-3 flex flex-col"> <span class="block text-sm font-medium"> No movement, plegia. <span class="text-sm font-bold">(4 points)</span> </span> </div> </label> <label class="rounded-tl-md rounded-tr-md relative border p-4 flex cursor-pointer focus:outline-none"><input type="radio" name="motorleftarm" x-on:click="motorleftarm = 0"> <div class="ml-3 flex flex-col"> <span class="block text-sm font-medium"> Not assessable, for example due to amputation. <span class="text-sm font-bold">(0 points)</span> </span> </div> </label> </fieldset>”
Text added:“<div class="relative"> <div class="absolute inset-0 flex items-center" aria-hidden="true"> <div class="w-full border-t border-gray-300"></div> </div> <div class="relative flex justify-center"> <span class="m-5 px-3 bg-white text-lg font-medium text-sky-600"> Motor Function of the Right Leg </span> </div> </div> <span class="relative flex justify-center text-lg font-medium text-gray-900 m-3">Hold the right leg for 5 seconds at 30 degrees lying. </span>”
Text added:“<fieldset> <label class="rounded-tl-md rounded-tr-md relative border p-4 flex cursor-pointer focus:outline-none"><input type="radio" name="motorrightleg" x-on:click="motorrightleg = 0"> <div class="ml-3 flex flex-col"> <span class="block text-sm font-medium"> No drift within 5 seconds. <span class="text-sm font-bold">(0 points)</span> </span> </div> </label> <label class="rounded-tl-md rounded-tr-md relative border p-4 flex cursor-pointer focus:outline-none"><input type="radio" name="motorrightleg" x-on:click="motorrightleg = 1"> <div class="ml-3 flex flex-col"> <span class="block text-sm font-medium"> Drift after less than 5 seconds but without touching the supporting surface. <span class="text-sm font-bold">(1 point)</span> </span> </div> </label> <label class="rounded-tl-md rounded-tr-md relative border p-4 flex cursor-pointer focus:outline-none"><input type="radio" name="motorrightleg" x-on:click="motorrightleg = 2"> <div class="ml-3 flex flex-col"> <span class="block text-sm font-medium"> Partial effort against gravity. Patient can hold the leg but cannot fully extend it or the leg drifts and touches the supporting surface. <span class="text-sm font-bold">(2 points)</span> </span> </div> </label> <label class="rounded-tl-md rounded-tr-md relative border p-4 flex cursor-pointer focus:outline-none"><input type="radio" name="motorrightleg" x-on:click="motorrightleg = 3"> <div class="ml-3 flex flex-col"> <span class="block text-sm font-medium"> No effort against gravity. <span class="text-sm font-bold">(3 points)</span> </span> </div> </label> <label class="rounded-tl-md rounded-tr-md relative border p-4 flex cursor-pointer focus:outline-none"><input type="radio" name="motorrightleg" x-on:click="motorrightleg = 4"> <div class="ml-3 flex flex-col"> <span class="block text-sm font-medium"> No movement, plegia. <span class="text-sm font-bold">(4 points)</span> </span> </div> </label> <label class="rounded-tl-md rounded-tr-md relative border p-4 flex cursor-pointer focus:outline-none"><input type="radio" name="motorrightleg" x-on:click="motorrightleg = 0"> <div class="ml-3 flex flex-col"> <span class="block text-sm font-medium"> Not assessable, for example due to amputation. <span class="text-sm font-bold">(0 points)</span> </span> </div> </label> </fieldset>”
Text added:“<div class="relative"> <div class="absolute inset-0 flex items-center" aria-hidden="true"> <div class="w-full border-t border-gray-300"></div> </div> <div class="relative flex justify-center"> <span class="m-5 px-3 bg-white text-lg font-medium text-sky-600"> Motor Function of the Left Leg </span> </div> </div> <span class="relative flex justify-center text-lg font-medium text-gray-900 m-3">Hold the left leg for 5 seconds at 30 degrees lying. </span> <fieldset> <label class="rounded-tl-md rounded-tr-md relative border p-4 flex cursor-pointer focus:outline-none"><input type="radio" name="motorleftleg" x-on:click="motorleftleg = 0"> <div class="ml-3 flex flex-col"> <span class="block text-sm font-medium"> No drift within 5 seconds. <span class="text-sm font-bold">(0 points)</span> </span> </div> </label> <label class="rounded-tl-md rounded-tr-md relative border p-4 flex cursor-pointer focus:outline-none"><input type="radio" name="motorleftleg" x-on:click="motorleftleg = 1"> <div class="ml-3 flex flex-col"> <span class="block text-sm font-medium"> Drift after less than 5 seconds but without touching the supporting surface. <span class="text-sm font-bold">(1 point)</span> </span> </div> </label> <label class="rounded-tl-md rounded-tr-md relative border p-4 flex cursor-pointer focus:outline-none"><input type="radio" name="motorleftleg" x-on:click="motorleftleg = 2"> <div class="ml-3 flex flex-col"> <span class="block text-sm font-medium"> Partial effort against gravity. Patient can hold the leg but cannot fully extend it or the leg drifts and touches the supporting surface. <span class="text-sm font-bold">(2 points)</span> </span> </div> </label> <label class="rounded-tl-md rounded-tr-md relative border p-4 flex cursor-pointer focus:outline-none"><input type="radio" name="motorleftleg" x-on:click="motorleftleg = 3"> <div class="ml-3 flex flex-col"> <span class="block text-sm font-medium"> No effort against gravity. <span class="text-sm font-bold">(3 points)</span> </span> </div> </label> <label class="rounded-tl-md rounded-tr-md relative border p-4 flex cursor-pointer focus:outline-none"><input type="radio" name="motorleftleg" x-on:click="motorleftleg = 4"> <div class="ml-3 flex flex-col"> <span class="block text-sm font-medium"> No movement, plegia. <span class="text-sm font-bold">(4 points)</span> </span> </div> </label> <label class="rounded-tl-md rounded-tr-md relative border p-4 flex cursor-pointer focus:outline-none"><input type="radio" name="motorleftleg" x-on:click="motorleftleg = 0"> <div class="ml-3 flex flex-col"> <span class="block text-sm font-medium"> Not assessable, for example due to amputation. <span class="text-sm font-bold">(0 points)</span> </span> </div> </label> </fieldset>”
Text added:“<div class="relative"> <div class="absolute inset-0 flex items-center" aria-hidden="true"> <div class="w-full border-t border-gray-300"></div> </div> <div class="relative flex justify-center"> <span class="m-5 px-3 bg-white text-lg font-medium text-sky-600">Ataxia</span> </div> </div> <span class="relative flex justify-center text-lg font-medium text-gray-900 m-3">Finger-nose test and heel-shin test bilaterally with eyes open. Do not test in case of incomplete wakefulness or plegia. </span> <fieldset> <label class="rounded-tl-md rounded-tr-md relative border p-4 flex cursor-pointer focus:outline-none"><input type="radio" name="ataxia" x-on:click="ataxia = 0"> <div class="ml-3 flex flex-col"> <span class="block text-sm font-medium"> No ataxia or not assessable, for example due to plegia. <span class="text-sm font-bold">(0 points)</span> </span> </div> </label> <label class="rounded-tl-md rounded-tr-md relative border p-4 flex cursor-pointer focus:outline-none"><input type="radio" name="ataxia" x-on:click="ataxia = 1"> <div class="ml-3 flex flex-col"> <span class="block text-sm font-medium"> Ataxia present in one limb. <span class="text-sm font-bold">(1 point)</span> </span> </div> </label> <label class="rounded-tl-md rounded-tr-md relative border p-4 flex cursor-pointer focus:outline-none"><input type="radio" name="ataxia" x-on:click="ataxia = 2"> <div class="ml-3 flex flex-col"> <span class="block text-sm font-medium"> Ataxia present in two or more limbs. <span class="text-sm font-bold">(2 points)</span> </span> </div> </label> </fieldset>”
Text added:“<div class="relative"> <div class="absolute inset-0 flex items-center" aria-hidden="true"> <div class="w-full border-t border-gray-300"></div> </div> <div class="relative flex justify-center"> <span class="m-5 px-3 bg-white text-lg font-medium text-sky-600">Sensory</span> </div> </div> <span class="relative flex justify-center text-lg font-medium text-gray-900 m-3">Testing with a pin on the face, arm, trunk and leg. In case of reduced vigilance, test with a painful stimulus.</span> <fieldset> <label class="rounded-tl-md rounded-tr-md relative border p-4 flex cursor-pointer focus:outline-none"><input type="radio" name="sensory" x-on:click="sensory = 0"> <div class="ml-3 flex flex-col"> <span class="block text-sm font-medium"> Normal sensation. <span class="text-sm font-bold">(0 points)</span> </span> </div> </label> <label class="rounded-tl-md rounded-tr-md relative border p-4 flex cursor-pointer focus:outline-none"><input type="radio" name="sensory" x-on:click="sensory = 1"> <div class="ml-3 flex flex-col"> <span class="block text-sm font-medium"> Partial loss of sensation. Touch on one side is weaker or only reacts to a painful stimulus. <span class="text-sm font-bold">(1 point)</span> </span> </div> </label> <label class="rounded-tl-md rounded-tr-md relative border p-4 flex cursor-pointer focus:outline-none"><input type="radio" name="sensory" x-on:click="sensory = 2"> <div class="ml-3 flex flex-col"> <span class="block text-sm font-medium">Severe or total loss of sensation. <span class="text-sm font-bold">(2 points)</span></span> </div> </label> </fieldset>”