How this calculator works
This page sums assessed item points and displays the item record. Administer items in the official order and follow the full NINDS instructions, including timing, positioning and special-case rules. UN is preserved and withholds a numeric total; it is not assigned zero or the item number 9. In coma the official instrument fixes the question, command, ataxia, sensory, language and dysarthria ratings, so those fields are assigned rather than offered. The result is an estimate for information only and is not medical advice.
Formula
NIHSS total = sum of the 15 numerical item ratings, including separate left/right arm and leg ratings. The maximum possible sum is 42. A complete numerical total requires every item to be numerically scored.
Worked example
One point each for gaze, face, left arm and dysarthria gives NIHSS 4 when every other item is 0. Left arm 2, left leg 2, sensory 1 and language 1 give 6.
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Frequently asked questions
Is an untestable item zero?
No. Preserve UN and its explanation. This page does not create a complete numeric total by inventing a score for an untestable item.
Does this page teach the NIHSS examination?
No. Short options help record a completed assessment. Use the official instructions, picture and word cards, positioning and timing, with appropriate training.
Can the total exclude stroke or determine treatment?
No. The item pattern and clinical context matter, and a low total can occur with important deficits. This page does not assign a treatment pathway or infer an unobserved item from a total.