Expanded Disability Status Scale

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The Expanded Disability Status Scale (EDSS) is a performance scale developed by John F. Kurtzke that indicates the severity of the disability in multiple sclerosis patients at the time of the survey. The scale begins at grade 0.0 and ends at grade 10.0, although higher grades are only reached by some of the patients in the course of the disease.

The doctor refers to the examination of the functional systems (FS) of the patient when determining the grade.

Functional Systems (FS)

EDSS grades

Degree Affected (FS) More detailed description
0.0 Grade 0 in all functional systems (FS) normal neurological exam
1.0 Grade 1 in a FS No disability, minimal abnormality in any functional system
1.5 Grade 1 in more than one FS No disability, minimal abnormality in more than 1 FS
2.0 Grade 2 in a FS (others 0 or 1) Minimal disability in 1 FS
2.5 Grade 2 in more than one FS (other 0 or 1) Minimal disability in 2 FS
3.0 Grade 2 in 3–4 FS or Grade 3 in a FS (others 0 or 1) Moderate disability in 1 FS or slight disability in 3–4 FS, but fully able to walk.
3.5 Grade 3 in 1 FS and Grade 2 in 1–2 FS or Grade 3 in 2 FS or Grade 2 in 5 FS, (others 0 or 1) Fully ambulatory, but with moderate disability in one FS (grade 3) and 1–2 FS grade 2; or two FS grade 3; or five FS grade 2
4.0 Grade 4 in a FS (others 0 or 1) Can walk without help and rest for at least 500 m. Active for about 12 hours a day despite a relatively severe disability
4.5 Grade 4 in a FS (others 0 or 1) Can walk without help and rest for at least 300 m. Able to work all day. Certain activity restriction, minimal assistance required, relatively severe disability.
5.0 Grade 5 in a FS (others 0 or 1); or a combination of lower grades but above grade 4.0 Can walk without help and rest for about 200 m. Disability severe enough to interfere with daily activity (e.g. working full time without special precautions).
5.5 like 5.0 Can walk without help and rest for about 100 m. Disability severe enough to prevent normal daily activity.
6.0 Combinations of grade 3 in more than 2 FS or more Intermittent, or constant on one side, support (crutch, stick, rail) is required to walk around 100 m without rest.
6.5 like 6.0 Constantly requires aids on both sides (crutch, stick, rail) to walk about 20 m without resting.
7.0 Combinations of grade 4 in more than 2 FS and more, rarely grade 5 pyramidal orbit alone Unable to walk more than 5 m even with help. Largely bound to a wheelchair. Moves the wheelchair himself and transfers without assistance.
7.5 like 7.0 Unable to take more than a few steps. Bound to a wheelchair. Needs help for transfer. Moves the wheelchair himself, but cannot spend the whole day in the wheelchair. May require a motorized wheelchair.
8.0 Combinations mostly of grade 4 and more in several FS Largely bound to bed or wheelchair; maintains itself largely independently. Mostly good use of arms.
8.5 like 8.0 Mostly tied to bed, even during the day. Some useful use of the arms, some self-care possible.
9.0 Combinations mostly grade 4 and more Helpless patient in bed. Can eat and communicate.
9.5 Combinations of almost exclusively grade 4 and more Completely helpless patient. Inability to eat, swallow, or communicate.
10.0 Death due to MS

literature

  • John F. Kurtzke: Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology (1983) vol. 33 (11) pp. 1444-1452. PMID 6685237 .

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