Parameters:
(1) facial palsy
(2) arm weakness
(3) speech impairment
The patient is asked to show his or her teeth and to smile. A positive result is the presence of a new facial asymmetry, including an uneven grimace or smile. The side of a positive result is recorded.
Arm strength is tested by lifting both arms to set positions (90° if sitting, 45° if supine), then asking the patient to hold them both there for 5 seconds. A positive result is if either arm drifts down or falls rapidly before the 5 seconds is up. The side of a positive result is recorded.
Speech is tested by listening for a new disturbance in speech including slurring or difficulty in finding words for common objects. If the patient has poor vision, then place a common object in the patient's hand and ask him or her to name it.
In a stroke the facial palsy and arm weakness should affect the same side if both are present.
|
Positive Finding
|
Percent of Stroke Patients
|
|
arm weakness
|
95%
|
|
speech disturbance
|
78%
|
|
facial paresis
|
69%
|
from Figure page 1357 Nor et al
Differential diagnosis of false positive results: seizures, intracranial infection, cerebral tumors, cardiovascular collapse and confusion.
