Canadian Neurological Scale
Citation, DOI & article data
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.
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
- 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
- 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
- face: symmetrical (0.5), asymmetrical (0)
- arms: equal (1.5), unequal (0)
- legs: equal (1.5), unequal (0)
Section B – patient stuporous or comatose
- use GCS
Scores range from 1.5 to 11.5, with a lower score indicating greater stroke severity.
- 1. Cote R, Hachinski VC, Shurvell BL, Norris JW, Wolfson C. The Canadian Neurological Scale: A Preliminary Study in Acute Stroke. Vol. 17, Stroke. 1986.
- 2. Côté R, Battista RN, Wolfson C, Boucher J, Adam J, Hachinski V. The Canadian neurological scale: Validation and reliability assessment. Neurology. 1989.
- 3. Nilanont Y, Komoltri C, Saposnik G, Côté R, Di Legge S, Jin Y, et al. The Canadian Neurological Scale and the NIHSS: Development and Validation of a Simple Conversion Model. Cerebrovasc Dis. 2010 Jul 22;30(2):120–6.