Stroke Score of Frithz and Werner (Modified Mathew Score)

Frithz and Werner used a somewhat simpler modification of the stroke score of Mathew et al (see below) to evaluate patients with acute stroke.

Factors examined during the neurological examination:

(1) level of consciousness (mentation)

(2) orientation (mentation)

(3) speech

(4) conjugate deviation of the eyes (cranial nerves)

(5) facial weakness (cranial nerves)

(6) motor power, left arm

(7) motor power, right arm

(8) motor power, left leg

(9) motor power, right leg

(10) performance disability status scale

(11) reflexes

(12) sensation

Factor	Finding	Points
level of consciousness	fully conscious	8
	somnolent	6
	pre-comatose	4
	comatose	0
orientation	oriented to person, time and place	6
	oriented x2	4
	oriented x1	2
	disoriented	0
speech	normal	23
	disconnected phrases	15
	aphasia	10
	dumb	0
conjugate deviation of eyes	intact (no conjugate deviation)	6
	conjugate deviation	0
facial weakness	intact	3
	palsy	0
motor power, left arm	normal strength	5
	paresis	2
	paralysis	0
motor power, right arm	normal strength	5
	paresis	2
	paralysis	0
motor power, left leg	normal strength	5
	paresis	2
	paralysis	0
motor power, right leg	normal strength	5
	paresis	2
	paralysis	0
performance disability status scale	normal	28
	moderate impairment	21
	considerable impairment	14
	severe impairment	7
	no performance at all	0
reflexes	normal	3
	spastic	1
	no reflexes elicited	0
sensation	normal	3
	mild sensory abnormality	2
	severe sensory abnormality	1
	no response to pain	0

where:

• Britton et al modified the scale slightly (combined oriented x2 and x1; combined mild and severe sensory abnormality)

stroke score =

= SUM(points for all 12 parameter)

Interpretation:

• minimum score: 0

• maximum score: 100.

• The higher the score, the less severe the impairment due to the stroke and the lower the mortality rate.

• The mortality rate is high with a total score < 15.

• An increasing score on the first day in the hospital was associated with better outcomes.

Performance:

• Using a cutoff of <= 24, sensitivity was 80% but specificity was low.

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