1.a. Level of Consciousness:

0 Alert

1 Not alert, but arousable with minimal stimulation

2 Not alert, requires repeated stimulation to attend

3 Coma

1.b. Ask patient the month and their age:

0 Answers both correctly

1 Answers one correctly

2 Both incorrect

1.c. Ask patient to open and close eyes and

0 Obeys both correctly

1 Obeys one correctly

2 Both incorrect

2. Best gaze (only horizontal eye movement):

0 Normal

1 Partial gaze palsy

2 Forced deviation

3. Visual Field testing:

0 No visual field loss

1 Partial hemianopia

2 Complete hemianopia

3 Bilateral hemianopia (blind including cortical blindness)

4. Facial Paresis (Ask patient to show

0 Normal symmetrical movement

teeth or raise eyebrows and close eyes

1 Minor paralysis (flattened nasolabial fold, asymmetry on smiling)

tightly):

2 Partial paralysis (total or near total paralysis of lower face)

3 Complete paralysis of one or both sides (absence of facial movement in the upper and lower face)

5. Motor Function - Arm (right and left):

0 Normal (extends arems 90 (or 45) degrees for 10 seconds without drift)

1 Drift

Right arm ____

2 Some effort against gravity

Left arm ____

3 No effort against gravity

4 No movement

9 Untestable (Joint fused or limb amputated)

6. Motor Function - Leg (right and left):

0 Normal (hold leg 30 degrees position for 5 seconds)

1 Drift

Right leg ____

2 Some effort against gravity

Left leg ____

3 No effort against gravity

4 No movement

9 Untestable (Joint fused or limb amputated)

7. Limb Ataxia:

0 No ataxia

1 Present in one limb

2 Present in two limbs

8. Sensory (Use pinprick to test arems, legs,

0 Normal

trunk and face -- compare side to side):

1 Mild to moderate decrease in sensation

2 Severe to total sensory loss

9. Best Language (describe picture, name items,

0 No aphasia

read sentences)

1 Mild to moderate aphasia

2 Severe aphasia

3 Mute

10. Dysarthria (read several words):

0 Normal articulation

1 Mild to moderate slurring of words

2 Near unintelligible or unable to speak

9 Intubated or other physical barrier

11. Extinction and inattention:

0 Normal

1 Inattention or extinction to bilateral simultaneous stimulation in one of the sensory modalities

6/24/97

2 Severe hemi-inattention or hemi-inattention to more than one modality