12. NIHSS: Best Language

A great deal of information about comprehension
will be obtained during the preceding sections of the examination.
For this scale item, the patient is asked to describe what is happening
in the attached picture, to name the items on the attached naming
sheet and to read from the attached list of sentences.
Comprehension is judged from responses here, as well as to all of
the commands in the preceding general neurological exam. If visual
loss interferes with the tests, ask the patient to identify objects placed
in the hand, repeat, and produce speech. The intubated patient
should be asked to write. The patient in a coma (item 1a=3) will
automatically score 3 on this item. The examiner must choose a
score for the patient with stupor or limited cooperation, but a score of
3 should be used only if the patient is mute and follows no one-step
commands.