Severe aphasia; all communication is through fragmentary expression; great need for inference, questioning, and guessing by the listener. Range of information that can be exchanged is limited; listener carries burden of communication. Examiner cannot identify materials provided from patient response. 3 . Mute, global aphasia; no usable speech

aphasia, the clarity of articulation of spontaneous speech can be rated. Only if the patient is intubated or has other physical barriers to producing speech, the examiner should record the score as untestable (UN), and clearly write an explanation for this choice. Do not tell the patient why he or she is being tested. 0 =

The NIH Stroke Scale/Score (NIHSS) quantifies stroke severity based on weighted evaluation findings.

The NIH offers training and certification in the administration and scoring of the stroke scale. An overview of the scale is listed below. The stroke scale items should be presented in order and the score should be reported after each numbered category has been assessed.

The National Institutes of Health Stroke Scale 8 (NIHSS) has become the standard for routine assessment of neurological deficits in the acute phase of stroke 9 and item 9, “Best Language,” evaluates aphasia.

patient has aphasia but does appear to attend to both sides, the score is normal. The presence of visual spatial neglector anosagnosia may also be taken as evidence of abnormality. Since the abnormality is scored only if present, the item is never untestable.

1 = Mild to moderate aphasia; some obvious loss of fluency or facility of comprehension, without significant limitation on ideas expressed or form of expression.

= Severe aphasia: all communication is through fragmentary expression; great need for inference, questioning, and guessing by the listener.

When using NIHSS for screening and diagnosing aphasia in adults with acute ischemic stroke, patients with severe aphasia can be detected, however, some mild aphasias might be misclassified. Given the 72% sensitivity, absence of aphasia on the NIHSS should not be used to guide stroke treatment.

Jan 11, 2017 · In other words, a skilled neurologist would not down-score a patient with aphasia for failing to answer 2 questions about orientation—the neurologist would know that the aphasia prevented valid testing of orientation (item 1b; Table 1).