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Rating neurologic impairment in multiple sclerosis: An expanded disability status scale (EDSS)
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Abstract
One method of evaluating the degree of neurologic impairment in MS has been the combination
of grades (0 = normal to 5 or 6 = maximal impairment) within 8 Functional Systems
(FS) and an overall Disability Status Scale (DSS) that had steps from 0 (normal) to
10 (death due to MS). A new Expanded Disability Status Scale (EDSS) is presented,
with each of the former steps (1,2,3 . . . 9) now divided into two (1.0, 1.5, 2.0
. . . 9.5). The lower portion is obligatorily defined by Functional System grades.
The FS are Pyramidal, Cerebellar, Brain Stem, Sensory, Bowel & Bladder, Visual, Cerebral,
and Other; the Sensory and Bowel & Bladder Systems have been revised. Patterns of
FS and relations of FS by type and grade to the DSS are demonstrated.