Canadian Neurological Scale

Dr Henry Knipe and Dr R Liong et al.

The Canadian Neurological Scale is a validated tool to evaluate stroke severity 1,2 designed to be performed on patients who are alert or drowsy. Patients who are stuporous or comatose are evaluated with the Glasgow Coma Scale (GCS) instead.

Classification

Section A is completed first. In the second part of the scale calculation, either section A1 or A2 is completed depending on whether a comprehension deficit is present or not. 

Section A – patient alert or drowsy
Mentation
  • level of consciousness: alert (3), drowsy (1.5)
  • orientation: oriented (1), disoriented or non-applicable (0)
  • speech: normal (1), expressive deficit(0.5), receptive deficit (0)
Section A1 – no comprehension deficit
Motor weakness
  • face: none (0.5), present (0)
  • arm proximal: none (1.5), mild (1), significant (0.5), total (0)
  • arm distal: none (1.5), mild (1), significant (0.5), total (0)
  • leg: none (1.5), mild (1), significant (0.5), total (0)
Section A2 - comprehension deficit
Motor response
  • face: symmetrical (0.5), asymmetrical (0)
  • arms: equal (1.5), unequal (0)
  • legs: equal (1.5), unequal (0)
Section B – patient stuporous or comatose

Interpretation

Scores range from 1.5 to 11.5, with a lower score indicating greater stroke severity.

Practical points

The Canadian Stroke Scale can be converted 3 to the National Institutes of Health Stroke Scale (NIHSS) using NIHSS = 23 - 2 x CNS

Stroke and intracranial haemorrhage

Article information

rID: 80497
Synonyms or Alternate Spellings:
  • Canadian Neurological Scale (CNS)
  • Canadian Neurological Stroke Scale

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