Expanded Disability Status Scale (EDSS) / Functional Systems Score (FSS)

Expanded Disability Status

Functional Systems

Pyramidal

Normal

Abnormal signs without disability

Minimal disability

Mild or moderate paraparesis or hemiparesis; severe monoparesis

Marked paraparesis or hemiparesis; moderate quadriparesis; or monoplegia

Paraplegia, hemiplegia, or marked quadriparesis

Quadriplegia

Brainstem

Normal

Signs only

Moderate nystagmus or other mild disability

Severe nystagmus, marked extraocular weakness, or moderate disability of other cranial nerves

Marked dysarthria or other marked disability

Inability to swallow or speak

Sensory

Normal

Vibration or figure-writing decrease only, in 1-2 limbs

Mild decrease in touch, pain or position sense, and/or moderate decrease in vibration in 1-2 limbs; or vibratory decrease alone in 3-4 limbs

Moderate decrease in touch, pain or position sense, and/or lost vibration in 1-2 limbs; or mild decrease in touch, pain and/or moderate decrease in all proprioceptive tests in 3-4 limbs

Marked decrease in touch or pain or loss of proprioception, alone or combined, in 1-2 limbs; or moderate decrease in touch, pain and/or severe proprioceptive decrease in >2 limbs

Loss of sensation in 1-2 limbs; or moderate decrease in touch, pain and/or loss of proprioception for most of the body below the head

Sensation essentially lost below the head

Bowel and bladder

Normal

Mild urinary hesitancy, urgency, or retention

Moderate hesitancy, urgency, retention of bowel or bladder, or rare urinary incontinence

Frequent urinary incontinence

In need of almost constant catheterization

Loss of bladder function

Loss of bowel and bladder function

Visual

Normal

Scotoma with visual acuity (corrected) better than 20/30

Worse eye with scotoma with maximal visual acuity (corrected) of 20/30 to 20/59

Worse eye with large scotoma, or moderate decrease in fields, but with maximal visual acuity (corrected) of 20/60 to 20/99

Worse eye with marked decrease of fields and maximal visual acuity (corrected) of 20/100-20/200; grade 3 plus maximal acuity of better eye of ≤20/60

Worse eye with maximal visual acuity (corrected) less than 20/200; grade 4 plus maximal acuity of better eye of 20/60 or less

Grade 5 plus maximal visual acuity of better eye of 20/60 or less

Cerebral

Normal

Mood alteration only (Does not affect DSS score)

Mild decrease in mentation

Moderate decrease in mentation

Marked decrease in mentation (chronic brain syndrome -- moderate)

Dementia or chronic brain syndrome -- severe or incompetent

Other

Normal

Any other neurologic findings attributed to MS

Calc Function

Expanded Disability Status Scale (EDSS) / Functional Systems Score (FSS)