1a Level of consciousness Examiner observation only — no painful stim needed beyond what differentiates the categories.
Ask the current month and the patient's age. Aphasia / intubation that prevents speech scores 2; clear dysarthria can still score 0.
Ask to open/close eyes and grip/release the non-paretic hand. Pantomime commands if there is a communication barrier.
Only assess horizontal eye movements.
Confrontation testing in upper and lower quadrants of each eye.
Ask patient to show teeth, raise eyebrows, close eyes.
Patient holds left arm extended 90° (sitting) or 45° (supine) for 10 seconds.
Patient holds right arm extended 90° (sitting) or 45° (supine) for 10 seconds.
Patient holds left leg at 30° (always supine) for 5 seconds.
Patient holds right leg at 30° (always supine) for 5 seconds.
Finger-nose-finger and heel-shin tests on both sides.
Pinprick on face, arms, trunk, legs — bilateral comparison.
Naming objects + reading + describing the cookie-theft picture.
Articulation only — not aphasia. Have patient read standard list of words.
11 Extinction / inattention Double simultaneous stimulation (visual + tactile).