Scoring, muscle weakness (NIS)
The Neuropathy Impairment Scoring System (NIS) strength: 0=normal; 1=25% weak (MRC equivalent= 5-); 2=50% weak (MRC equivalent 4+); 3=75% weak (MRC equivalent 4-); 3.25%=movement against gravity (MRC equivalent 3); 3.5=movement, gravity eliminated (MRC equivalent 2); 3.75; flicker of movement (MRC equivalent 1) 4=complete paralysis (MRC equivalent 0).
Right/Left
Deficit/Deficit
Visual Acuity
Fundus
0 Pupil light reflex
0 Hearing loss
Right Cranial Left
Strength Strength
0 3rd nerve 0
4th nerve
6th nerve 0
Facial weakness 0
Temporal-Masseter 0
Forehead 0
Orbicularis Oculi 0
Orbicularis Oris 0
0 * Palate weakness 0
0 Sternocleidomastoid 0
0 Trapezius 0
0 * Tongue weakness 0
Right Cervical Left
Strength Strength
0 * Neck flexion 0
0 Neck extension 0
0 Infraspinatus 0
0 Supraspinatus 0
0 Pectoralis 0
0 * Deltoid 0
0 * Elbow flexion 0
0 * Brachioradialis 0
0 * Elbow extension 0
0 * Wrist extension 0
0 * Wrist flexion 0
0 Supinator 0
0 Pronator 0
0 Finger extension 0
0 * Finger flexion 0
0 * Thumb abduction 0
0 Thumb flexion 0
0 * Finger spread 0
0 Hypothenar 0
0 Abdominal muscles 0
0 * Respiratory 0
Right Lumbosacral Left
Strength Strength
-3.75 * Hip flexion -2
-3 * Hip extension -1
Hip internal rotation
-3 Hip adduction -1
-3 Hip abduction -1
-3.75 * Knee extension -2
-3.25 * Knee flexion -2
-4 * Ankle dorsiflexors -4
-3 * Ankle plantar flexors -4
-4 * Toe extensors -4
-3 * Toe flexors -4
-3 Extensor hallicus -4
Ankle evertors
Ankle invertors
Scoring, reflexes (* NIS)
NIS (Normal= 0 or above 0; Reduced= -1 to -3; Absent=-4)
Right Reflexes Left
-1 * Biceps brachii -1
-1 * Brachioradialis -1
-1 * Triceps brachii -1
0 Hoffmann 0
-4 * Quadriceps femoris -2
-4 * Gastroc. soleus -4
Clonus
Plantar response
Scoring, sensation (* NIS)
NIS (Normal= 0 or above 0; Reduced= -1 to -3; Absent=-4)
Right Sensation - Index finger Left
0 * Touch-pressure 0
* Pin-prick
Heat-pain
Cold-sensation
* Vibration
0 * Joint position 0
Right Sensation - Great Toe Left
-1 * Touch-pressure -1
* Pin-prick
Heat-pain
Cold-sensation
* Vibration
-1 * Joint position -4
SUMMED SCORES (0 is normal)
Strength (Range) Reflex (Range) Sensation (Range) Total
Score (Range)
Total
Scores 65.75 (0-376) 20 (0-64) 7 (0-96) 92.75 (0-536)