Canadian Neurological Scale
What It Measures
The Canadian Neurological Scale (CNS) is a quick bedside check of how much a stroke has affected someone in the first hours and days, and whether they are getting better or worse. It is built for patients who are alert or drowsy; anyone stuporous or comatose is monitored with the Glasgow Coma Scale instead.
Section A covers level of consciousness, orientation, and speech. Motor function then follows one of two paths. Section A1 is used when the person can understand and follow instructions; section A2 is used when comprehension is impaired, scoring facial and limb asymmetry instead. Items are weighted by how much each deficit matters and summed to a total from 1.5 to 11.5, where lower means more severe.
Further Reading
Additional Notes
Licensing Notes: The scale is reproduced freely in clinical practice guidelines, including the Canadian Stroke Best Practice Recommendations, and on hospital and stroke network sites.
Learn More: The CNS focuses on limb weakness over other neurological impairments, and it scores only the weakest limb, so upper and lower extremity strength may need separate documentation. Clinically, a drop of more than one point is treated as a trigger to notify the physician immediately.
