cliot (version 1.0.0)

modified_nih_stroke_scale: 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)

Value

A list containing:

mNIHSS_Score

The calculated total score (Range 0-31).

Severity

Interpretation of stroke severity (Minor, Moderate, Severe).

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.

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)