The Texas Stroke Intervention Pre-Hospital Stroke Severity Scale (LEGS score) can help in the pre-hospital assessment of a stroke victim. The authors are from the Texas Stroke Institute, HCA North Texas Division, Dallas-Forth Worth.
LEGS is an acronym for leg strength, eyes, gaze deviation and speech difficulty
Patient selection: stroke
Parameters:
(1) left lower extremity strength
(2) right lower extremity strength
(3) eyes and visual fields
(4) gaze deviation
(5) speech and language difficulty
Parameter
Finding
Points
left leg strength
no drift
0
drift
1
some effort against gravity
2
no effort against gravity
3
no movement
4
right leg strength
no drift
0
drift
1
some effort against gravity
2
no effort against gravity
3
no movement
4
eyes and visual fields
no visual field defect
0
upper OR lower visual field defect
1
upper AND lower visual field defect
2
blind in both eyes
3
gaze
no gaze paralysis
0
partial gaze paralysis
1
forced deviation to one side
2
speech/language
normal
0
mild loss of fluency or comprehension
1
incomprehensible
2
mute
3
comatose
3
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimal score: 0
• maximum score: 16
Total Score
Last Known Normal (LKN)
Brain Bleed Suspected
Transfer
<= 3
NA
No
primary stroke center or stroke support facility
>= 4
< 3 hours
No
primary stroke center or stroke support facility; start fibrinolytic then transfer to comprehensive stroke center
>= 4
> 3 hours
No
comprehensive stroke center
NA
NA
Yes
comprehensive stroke center
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