# Modified NIH Stroke Scale mNIHSS Status: LIVE Price: $0.005 USDC `GET /api/calc/mnihss` HTML: https://magentlab.com/docs/mnihss Markdown: https://magentlab.com/docs/mnihss.md Not a medical device. Not a diagnosis, dose, or listing recommendation. ## What it computes Sum Meyer/Lyden 2001 modified NIH stroke scale points from 11 caller-assigned NINDS-style examination integers, with left/right motor and sensory collapsed to 0-1. Does not apply total-score severity bands. ## When to use When an agent already has Meyer 2001 mNIHSS integers and needs that published total. magent does not examine the patient, score Brott 1989 15-item NIHSS, or issue a tPA order. ## When not to use - Not a medical device. magent does not examine the patient. Each item is a caller-assigned Meyer 2001 integer. Not a diagnosis. - This is the Meyer/Lyden 2001 modified NIHSS (NINDS 11-item form): drops LOC, facial palsy, limb ataxia, and dysarthria; collapses sensory to 0 = normal or 1 = abnormal; keeps left and right motor arm and leg. It is not Brott 1989 15-item NIHSS (weaker-limb motor, pupillary response, plantar reflex). Not a tPA order. - Meyer 2001 published no total-score mild/moderate/severe cutoffs. This tool returns score and max_score only. It does not apply later 5/15/20 website cuts. ## Formula ``` mNIHSS = loc_questions (0-2) + loc_commands (0-2) + best_gaze (0-2) + best_visual (0-3) + left_arm (0-4) + right_arm (0-4) + left_leg (0-4) + right_leg (0-4) + sensory (0-1) + best_language (0-3) + neglect (0-2); Meyer/Lyden 2001 modified NIHSS (NINDS 11-item form; L/R motor; sensory collapsed to 0-1); total = sum; max 31; no published total-score severity bands ``` ## Citation [A modified National Institutes of Health Stroke Scale for use in stroke clinical trials: preliminary reliability and validity](https://doi.org/10.1161/01.str.32.6.1310) Meyer BC, Hemmen TM, Jackson CM, Lyden PD Stroke. 2001;32(6):1310-1317 DOI: [10.1161/01.str.32.6.1310](https://doi.org/10.1161/01.str.32.6.1310) ## Worked example ### All items at published minimum Given: `best_gaze=0, best_language=0, best_visual=0, left_arm=0, left_leg=0, loc_commands=0, loc_questions=0, neglect=0, right_arm=0, right_leg=0, sensory=0` 1. loc_questions, loc_commands, best_gaze, best_visual, left_arm, right_arm, left_leg, right_leg, sensory, best_language, and neglect are 0 as assigned by the caller 2. Score = 0 (max 31). Meyer 2001 published no total-score severity band. ### All items at published maximum Given: `best_gaze=2, best_language=3, best_visual=3, left_arm=4, left_leg=4, loc_commands=2, loc_questions=2, neglect=2, right_arm=4, right_leg=4, sensory=1` 1. each Meyer 2001 mNIHSS item is at that paper's published maximum as assigned by the caller 2. Score = 31 (max 31). No total-score severity band. ## Also searched as - modified NIH Stroke Scale - mNIHSS - Meyer 2001 mNIHSS - modified National Institutes of Health Stroke Scale - NINDS 11-item NIHSS - mNIHSS stroke score - Lyden Meyer modified NIHSS ## Parameters - `loc_questions` (integer, required): Caller-assigned Meyer 2001 LOC questions (integer 0-2): 0 answers both correctly, 1 answers one correctly, 2 incorrect. magent does not examine the patient. - `loc_commands` (integer, required): Caller-assigned Meyer 2001 LOC commands (integer 0-2): 0 obeys both correctly, 1 obeys one correctly, 2 incorrect. magent does not examine the patient. - `best_gaze` (integer, required): Caller-assigned Meyer 2001 best gaze (integer 0-2): 0 normal, 1 partial gaze palsy, 2 forced deviation. magent does not examine the patient. - `best_visual` (integer, required): Caller-assigned Meyer 2001 best visual (integer 0-3): 0 no visual loss, 1 partial hemianopia, 2 complete hemianopia, 3 bilateral hemianopia. magent does not examine the patient. - `left_arm` (integer, required): Caller-assigned Meyer 2001 left arm motor, NINDS style (integer 0-4): 0 no drift, 1 drift, 2 some effort against gravity, 3 no effort against gravity, 4 no movement. Not Brott weaker-limb. magent does not examine the patient. - `right_arm` (integer, required): Caller-assigned Meyer 2001 right arm motor, NINDS style (integer 0-4): 0 no drift, 1 drift, 2 some effort against gravity, 3 no effort against gravity, 4 no movement. Not Brott weaker-limb. magent does not examine the patient. - `left_leg` (integer, required): Caller-assigned Meyer 2001 left leg motor, NINDS style (integer 0-4): 0 no drift, 1 drift, 2 some effort against gravity, 3 no effort against gravity, 4 no movement. Not Brott weaker-limb. magent does not examine the patient. - `right_leg` (integer, required): Caller-assigned Meyer 2001 right leg motor, NINDS style (integer 0-4): 0 no drift, 1 drift, 2 some effort against gravity, 3 no effort against gravity, 4 no movement. Not Brott weaker-limb. magent does not examine the patient. - `sensory` (integer, required): Caller-assigned Meyer 2001 sensory (integer 0-1): 0 normal, 1 abnormal. Collapsed from NIHSS 0-2; 2 is invalid. magent does not examine the patient. - `best_language` (integer, required): Caller-assigned Meyer 2001 best language (integer 0-3): 0 no aphasia, 1 mild to moderate, 2 severe aphasia, 3 mute. magent does not examine the patient. - `neglect` (integer, required): Caller-assigned Meyer 2001 neglect (integer 0-2): 0 no neglect, 1 partial neglect, 2 complete neglect. magent does not examine the patient. ## Bulk (POST) POST the same path with a JSON items array. The first item is the GET unit; each additional item is $0.002. Invalid items return HTTP 400 before settlement. Method: `POST /api/calc/mnihss` Max items: 25 Price: unit_amount + extra_item_amount * (n - 1) (unit 5000 atomic, extra 2000 atomic) Status: PREVIEW - 1 to 25 items. Each item uses the same keys as the GET query parameters. - POST of 1 item costs the same as GET. Lists longer than 25: chunk into multiple POSTs. Extra items still execute; do not pad dummy rows. - The first invalid item fails the whole request (index in the 400 JSON). You are not charged. - HTTP 200 is {count, path, items}. Each items[i] is the GET 200 body for that row. - Catalog misses (empty matches, found=false) stay paid 200s inside that slot. - x402 resource URL is this path plus n and body_sha256. Browsers that prefer text/html get the same paywall as GET; Pay retries POST with the same items. Example request: ```json { "items": [ { "best_gaze": "0", "best_language": "0", "best_visual": "0", "left_arm": "0", "left_leg": "0", "loc_commands": "0", "loc_questions": "0", "neglect": "0", "right_arm": "0", "right_leg": "0", "sensory": "0" }, { "best_gaze": "0", "best_language": "0", "best_visual": "0", "left_arm": "0", "left_leg": "0", "loc_commands": "0", "loc_questions": "0", "neglect": "0", "right_arm": "0", "right_leg": "0", "sensory": "0" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/mnihss Example 200: ```json { "count": 2, "path": "/api/calc/mnihss", "items": [ { "components": [ { "value": 0, "factor": "loc_questions", "points": 0, "present": true }, { "value": 0, "factor": "loc_commands", "points": 0, "present": true }, { "value": 0, "factor": "best_gaze", "points": 0, "present": true }, { "value": 0, "factor": "best_visual", "points": 0, "present": true }, { "value": 0, "factor": "left_arm", "points": 0, "present": true }, { "value": 0, "factor": "right_arm", "points": 0, "present": true }, { "value": 0, "factor": "left_leg", "points": 0, "present": true }, { "value": 0, "factor": "right_leg", "points": 0, "present": true }, { "value": 0, "factor": "sensory", "points": 0, "present": true }, { "value": 0, "factor": "best_language", "points": 0, "present": true }, { "value": 0, "factor": "neglect", "points": 0, "present": true } ], "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.", "citation": { "authors": "Meyer BC, Hemmen TM, Jackson CM, Lyden PD", "doi": "10.1161/01.str.32.6.1310", "id": "meyer-2001", "pmid": "11387492", "source": "Stroke. 2001;32(6):1310-1317", "title": "A modified National Institutes of Health Stroke Scale for use in stroke clinical trials: preliminary reliability and validity" }, "formula": "mnihss", "formula_expression": "mNIHSS = loc_questions (0-2) + loc_commands (0-2) + best_gaze (0-2) + best_visual (0-3) + left_arm (0-4) + right_arm (0-4) + left_leg (0-4) + right_leg (0-4) + sensory (0-1) + best_language (0-3) + neglect (0-2); Meyer/Lyden 2001 modified NIHSS (NINDS 11-item form; L/R motor; sensory collapsed to 0-1); total = sum; max 31; no published total-score severity bands", "max_score": 31, "score": 0 }, { "components": [ { "value": 0, "factor": "loc_questions", "points": 0, "present": true }, { "value": 0, "factor": "loc_commands", "points": 0, "present": true }, { "value": 0, "factor": "best_gaze", "points": 0, "present": true }, { "value": 0, "factor": "best_visual", "points": 0, "present": true }, { "value": 0, "factor": "left_arm", "points": 0, "present": true }, { "value": 0, "factor": "right_arm", "points": 0, "present": true }, { "value": 0, "factor": "left_leg", "points": 0, "present": true }, { "value": 0, "factor": "right_leg", "points": 0, "present": true }, { "value": 0, "factor": "sensory", "points": 0, "present": true }, { "value": 0, "factor": "best_language", "points": 0, "present": true }, { "value": 0, "factor": "neglect", "points": 0, "present": true } ], "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.", "citation": { "authors": "Meyer BC, Hemmen TM, Jackson CM, Lyden PD", "doi": "10.1161/01.str.32.6.1310", "id": "meyer-2001", "pmid": "11387492", "source": "Stroke. 2001;32(6):1310-1317", "title": "A modified National Institutes of Health Stroke Scale for use in stroke clinical trials: preliminary reliability and validity" }, "formula": "mnihss", "formula_expression": "mNIHSS = loc_questions (0-2) + loc_commands (0-2) + best_gaze (0-2) + best_visual (0-3) + left_arm (0-4) + right_arm (0-4) + left_leg (0-4) + right_leg (0-4) + sensory (0-1) + best_language (0-3) + neglect (0-2); Meyer/Lyden 2001 modified NIHSS (NINDS 11-item form; L/R motor; sensory collapsed to 0-1); total = sum; max 31; no published total-score severity bands", "max_score": 31, "score": 0 } ] } ``` ## Response fields - `formula` (string): mnihss - `formula_expression` (string): Exact expression used - `score` (integer): Meyer 2001 mNIHSS sum of 11 caller-assigned NINDS-style examination items (0-31) - `max_score` (integer): Always 31 - `components` (array): Per-item caller-assigned points - `citation` (object): Meyer Stroke 2001 citation - `disclaimer` (string): Not-a-device notice ## Example JSON Frozen fixture. Not a live lookup. ```json { "components": [ { "value": 0, "factor": "loc_questions", "points": 0, "present": true }, { "value": 0, "factor": "loc_commands", "points": 0, "present": true }, { "value": 0, "factor": "best_gaze", "points": 0, "present": true }, { "value": 0, "factor": "best_visual", "points": 0, "present": true }, { "value": 0, "factor": "left_arm", "points": 0, "present": true }, { "value": 0, "factor": "right_arm", "points": 0, "present": true }, { "value": 0, "factor": "left_leg", "points": 0, "present": true }, { "value": 0, "factor": "right_leg", "points": 0, "present": true }, { "value": 0, "factor": "sensory", "points": 0, "present": true }, { "value": 0, "factor": "best_language", "points": 0, "present": true }, { "value": 0, "factor": "neglect", "points": 0, "present": true } ], "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.", "citation": { "authors": "Meyer BC, Hemmen TM, Jackson CM, Lyden PD", "doi": "10.1161/01.str.32.6.1310", "id": "meyer-2001", "pmid": "11387492", "source": "Stroke. 2001;32(6):1310-1317", "title": "A modified National Institutes of Health Stroke Scale for use in stroke clinical trials: preliminary reliability and validity" }, "formula": "mnihss", "formula_expression": "mNIHSS = loc_questions (0-2) + loc_commands (0-2) + best_gaze (0-2) + best_visual (0-3) + left_arm (0-4) + right_arm (0-4) + left_leg (0-4) + right_leg (0-4) + sensory (0-1) + best_language (0-3) + neglect (0-2); Meyer/Lyden 2001 modified NIHSS (NINDS 11-item form; L/R motor; sensory collapsed to 0-1); total = sum; max 31; no published total-score severity bands", "max_score": 31, "score": 0 } ``` ## Errors - HTTP 400 `invalid_mnihss`: mNIHSS needs eleven NINDS-style items (Lyden/Meyer 2001; not Brott 1989 NIHSS). Returned before settlement; you are not charged. - HTTP 400 `invalid_mnihss_item`: each mNIHSS item must be an integer in that item's published range (Meyer 2001). Returned before settlement; you are not charged. - HTTP 400 `invalid_items`: POST body must be a JSON object with only an items array Returned before settlement; you are not charged. - HTTP 400 `invalid_item_count`: items must be an array of 1 to 25 objects Returned before settlement; you are not charged. - HTTP 400 `invalid_item`: each items entry must be a JSON object Returned before settlement; you are not charged. Shared HTTP 402 and 503: https://magentlab.com/docs/payments ## Related tools - [NIHSS](https://magentlab.com/docs/nihss) — Sum Brott 1989 NIH stroke scale points from 15 caller-assigned examination integers, including pupillary response and plantar reflex. Weaker-limb motor arm and leg. Does not apply later total-score severity bands. - [Glasgow Coma Scale](https://magentlab.com/docs/gcs) — Compute the Glasgow Coma Scale as the sum of caller-assigned eye, verbal, and motor integers. The 1974 or 1976 edition is required. ## Payment Unpaid requests return HTTP 402 even if query parameters or POST items are missing or invalid, so CDP and agents can index the path. After a PAYMENT-SIGNATURE, invalid params return HTTP 400 JSON before settlement. magent does not charge. Fix the params, then request a new 402 quote for that complete URL. Catalog misses (empty matches, found=false) are valid paid 200s. - GET the tool with Accept: application/json (do not send Accept: text/html unless you want the human paywall). - HTTP 402 means you have not paid. Decode the base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote. - Sign accepts[0] (exact, EIP-3009) with validBefore = now + maxTimeoutSeconds (600 seconds), or accepts[1] (batch-settlement deposit/voucher) on product GET. Ping and POST {items} stay exact. Magent retries transient facilitator 429/5xx before answering. - Retry the same URL with PAYMENT-SIGNATURE (base64 JSON of accepted and payload). Magent attaches canonical extensions.bazaar on CDP verify/settle; echoing 402 bazaar is optional. - Success is HTTP 200 JSON plus PAYMENT-RESPONSE. exact settles before the tool. batch-settlement verifies (and deposit-settles) before the tool and commits the charge after HTTP 2xx. HTTP 503: retry the same PAYMENT-SIGNATURE. Mint a new exact nonce only after a new HTTP 402. - offered `exact` on eip155:8453: Fixed-price USDC on Base. The buyer authorizes the advertised amount (EIP-3009). magent settles before the tool runs (paymentFlow upfront). extra.assetTransferMethod=eip3009 extra.paymentFlow=upfront. - offered `batch-settlement` on eip155:8453: Payment-channel vouchers claimed later in batches. Exact stays accepts[0]. Same-path POST {items} is still exact. extra.assetTransferMethod=eip3009 extra.paymentFlow=authorization. - not offered `upto`: Not offered. Usage-based: buyer authorizes a ceiling, seller settles the actual amount after work. Reserved for a future metered tool. Not for current calculators or code search. Same-path POST {items} is still scheme exact: one EIP-3009 authorization for GET unit plus $0.002 per extra item. That is not x402 batch-settlement (payment channels / vouchers). Shared HTTP 402 and 503 table: https://magentlab.com/docs/payments Stdio MCP (one process per host): https://magentlab.com/docs/mcp ## Guarantees - HTTP 402 is unpaid, including a missing query. After PAYMENT-SIGNATURE, invalid parameters return HTTP 400 before settlement. You are not charged. HTTP 402 never includes the tool JSON. - exact: settlement finishes before the tool (paymentFlow upfront). batch-settlement: verify/deposit before the tool; chargedCumulativeAmount commits after HTTP 2xx. Uncertain or failed settlement fails closed (HTTP 503). Retry the same PAYMENT-SIGNATURE. - HTTP 402 is unpaid only. Do not sign a second authorization because of a 503. - Execution is timeout-bounded and concurrency-capped. - Calculator inputs are stored encrypted for allowlisted operators (Magent Console). They are not in public logs, SSH lookups, catalog, or rollups. Request logs store path without query.