WebMD Medical Reference
Reviewed By Neil Lava, MD
Multiple sclerosis (MS) is a complex
disease. Multiple sclerosis progression varies from person to person. And, the
various MS types of disease progress in different ways, too. Scans and other
multiple sclerosis tests don’t always tell the whole story about MS disability.
Signs and symptoms and how well you are functioning each day — from seeing to
moving to thinking — are also important measures of how well your central
nervous system is working.
disease. Multiple sclerosis progression varies from person to person. And, the
various MS types of disease progress in different ways, too. Scans and other
multiple sclerosis tests don’t always tell the whole story about MS disability.
Signs and symptoms and how well you are functioning each day — from seeing to
moving to thinking — are also important measures of how well your central
nervous system is working.
That’s why a variety of tools are
useful in assessing multiple sclerosis disability. These help you and your
doctor gauge whether your MS is improving, progressing, or staying about the
same. Doctors also use these measures in clinical studies. This helps to see
how well multiple sclerosis treatment is working.
useful in assessing multiple sclerosis disability. These help you and your
doctor gauge whether your MS is improving, progressing, or staying about the
same. Doctors also use these measures in clinical studies. This helps to see
how well multiple sclerosis treatment is working.
A trained examiner, often a
neurologist, administers tests that help create scales like the ones below.
These can provide a kind of snapshot of your MS progression.
neurologist, administers tests that help create scales like the ones below.
These can provide a kind of snapshot of your MS progression.
MS Progression: Expanded Disability
Status Scale (EDSS)
Status Scale (EDSS)
This commonly used scale is sometimes
called the Kurtzke scale, named for the neurologist who developed it. The EDSS
focuses mainly on your ability to walk. It is a less sensitive measure of other
types of multiple sclerosis disability. It takes about 30 minutes to create a
score. Then a few minutes are needed to establish the ratings in the EDSS
scale.
called the Kurtzke scale, named for the neurologist who developed it. The EDSS
focuses mainly on your ability to walk. It is a less sensitive measure of other
types of multiple sclerosis disability. It takes about 30 minutes to create a
score. Then a few minutes are needed to establish the ratings in the EDSS
scale.
Functional System Score (FSS)
On a scale of 0 to 6, FSS measures
how well your major central nervous systems are working and assigns a score to
your disability. This incorporates information about your gait and use of
assistive devices. It also involves observation of functions like these:
how well your major central nervous systems are working and assigns a score to
your disability. This incorporates information about your gait and use of
assistive devices. It also involves observation of functions like these:
Weakness or trouble moving limbs
Tremor or loss of coordination
Problems with speech, swallowing, or
involuntary eye movements
involuntary eye movements
Numbness or loss of sensation
Bowel and bladder function
Visual function
Mental functions
The EDSS Scale
With the help of the FSS, the
examiner rates your disability on the EDSS scale. It ranges from 0 to 10, with
half points for greater specificity. Lower numbers indicate less severe
disability. Higher numbers reflect a greater degree of disability, mostly in
relation to mobility:
examiner rates your disability on the EDSS scale. It ranges from 0 to 10, with
half points for greater specificity. Lower numbers indicate less severe
disability. Higher numbers reflect a greater degree of disability, mostly in
relation to mobility:
0 = Normal
1-1.5 = No disability, but some
abnormal neurological signs
abnormal neurological signs
2–2.5 = Minimal disability
3–4.5 = Moderate disability,
affecting daily activities, but you can still walk
affecting daily activities, but you can still walk
5–8 = More severe disability,
impairing your daily activities and requiring assistance with walking
impairing your daily activities and requiring assistance with walking
8.5–9.5 = Very severe disability,
restricting you to bed
restricting you to bed
10 = Death
It’s important to recognize that a
one-point change at the lower end of the scale reflects more subtle changes
than at the upper end of the scale. For example, a one-point change between 2
and 3 is not as great a progression of disability as between 8 and 9.
one-point change at the lower end of the scale reflects more subtle changes
than at the upper end of the scale. For example, a one-point change between 2
and 3 is not as great a progression of disability as between 8 and 9.
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