Expanded Disability Status Scale

The Kurtzke Expanded Disability Status Scale (EDSS) is a method of quantifying disability in multiple sclerosis.^[1] The scale has been developed by John F. Kurtzke.

The EDSS quantifies disability in eight Functional Systems (FS) and allows neurologists to assign a Functional System Score (FSS) in each of these.

Functional systems

Kurtzke defines functional systems as follows:^[1]

Results and clinical meaning

EDSS steps 1.0 to 4.5 refer to people with MS who are fully ambulatory. EDSS steps 5.0 to 9.5 are defined by the impairment to ambulation.

The clinical meaning of each possible result is the following:

0.0: Normal Neurological Exam
1.0: No disability, minimal signs in 1 FS
1.5: No disability, minimal signs in more than 1 FS
2.0: Minimal disability in 1 FS
2.5: Mild disability in 1 or Minimal disability in 2 FS
3.0: Moderate disability in 1 FS or mild disability in 3 - 4 FS, though fully ambulatory
3.5: Fully ambulatory but with moderate disability in 1 FS and mild disability in 1 or 2 FS; or moderate disability in 2 FS; or mild disability in 5 FS
4.0: Fully ambulatory without aid, up and about 12hrs a day despite relatively severe disability. Able to walk without aid 500 meters
4.5: Fully ambulatory without aid, up and about much of day, able to work a full day, may otherwise have some limitations of full activity or require minimal assistance. Relatively severe disability. Able to walk without aid 300 meters
5.0: Ambulatory without aid for about 200 meters. Disability impairs full daily activities
5.5: Ambulatory for 100 meters, disability precludes full daily activities
6.0: Intermittent or unilateral constant assistance (cane, crutch or brace) required to walk 100 meters with or without resting
6.5: Constant bilateral support (cane, crutch or braces) required to walk 20 meters without resting
7.0: Unable to walk beyond 5 meters even with aid, essentially restricted to wheelchair, wheels self, transfers alone; active in wheelchair about 12 hours a day
7.5: Unable to take more than a few steps, restricted to wheelchair, may need aid to transfer; wheels self, but may require motorized chair for full day's activities
8.0: Essentially restricted to bed, chair, or wheelchair, but may be out of bed much of day; retains self care functions, generally effective use of arms
8.5: Essentially restricted to bed much of day, some effective use of arms, retains some self care functions
9.0: Helpless bed patient, can communicate and eat
9.5: Unable to communicate effectively or eat/swallow
10.0: Death due to MS

References

1 2 Kurtzke JF (1983). "Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS)". Neurology. 33 (11): 1444–52. doi:10.1212/WNL.33.11.1444. PMID 6685237.

Multiple sclerosis and other demyelinating diseases of CNS (G35–G37, 340–341)

Signs and symptoms	Ataxia Depression Diplopia Dysarthria Dysphagia Fatigue Incontinence Neurological fatigue Nystagmus Optic neuritis Pain Uhthoff's phenomenon Dawson's fingers

Diagnosis and evolution following	Diagnostic criteria for MS McDonald criteria Poser criteria EDSS Clinically isolated syndrome

Investigation	Pathophysiology Experimental autoimmune encephalomyelitis Multiple sclerosis drug pipeline Multiple sclerosis research

Approved Treatment	Interferon beta 1b Glatiramer acetate Interferon beta 1a Mitoxantrone Natalizumab Fingolimod Teriflunomide Dimethyl fumarate Alemtuzumab Daclizumab

Borderline forms	Acute disseminated encephalomyelitis Balo concentric sclerosis Neuromyelitis optica Marburg multiple sclerosis Schilder's disease Tumefactive multiple sclerosis (Autoimmune PNS diseases like Guillain-Barré syndrome and CIDP are normally set apart) AntiMOG associated encephalomyelitis

Other	List of people with multiple sclerosis List of multiple sclerosis organizations

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