Functional Systems



The EDSS is based upon Neurological testing of Functional Systems (CNS areas regulating body functions): Pyramidal (ability to walk), Cerebellar (Coordination), BrainStem (Speech and Swallowing), Sensory (Touch and Pain), Bowel and Bladder; Visual; Mental; and "Other" (includes any other Neurological findings due to Multiple Sclerosis).

Each Functional System (FS) is graded to the nearest possible grade, and V indicates an unknown abnormality; these are not additive scores and are only used for comparison of individual items.


  1. Pyramidal Function
    0 - Normal
    1 - Abnormal Signs without Disability
    2 - Minimal disability
    3 - Mild/Moderate ParaParesis of HemiParesis; Severe MonoParesis
    4 - Marked ParaParesis or HemiParesis; Moderate QuadraParesis or MonoParesis
    5 - Paraplegia, Hemiplegia, or Marked ParaParesis
    6 - Quadriplegia
    V - Unknown

  2. Cerebellar Function
    0 - Normal
    1 - Abnormal Signs without disability
    2 - Mild Ataxia
    3 - Moderate Truncal or Limb Ataxia
    4 - Severe Ataxia
    5 - Unable to perform Coordinated Movements
    V - Unknown
    X - Weakness

  3. BrainStem Function
    0 - Normal
    1 - Signs only
    2 - Moderate Nystagmus or other mild disability
    3 - Severe Nystagmus, Marked ExtraOcular Weakness or moderate disability of other Cranial Nerves
    4 - Marked Dysarthria or other marked disability
    5 - Inability to Speak or Swallow
    V - Unknown

  4. Sensory Function
    0 - Normal
    1 - Vibration or Figure - Writing decrease only, in 1 or 2 limbs
    2 - Mild decrease in Touch or Pain or Position Sense, and/or moderate decrease in Vibration in 1 or 2 limb, or Vibration in 3 or 4 limbs
    3 - Moderate decrease in Touch or Pain or Proprioception, and/or essentially lost Vibration in 1 or 2 limbs; or mild decrease in Touch or Pain and/or moderate decrease in all Proprioceptive tests in 3 or 4 limbs
    4 - Marked decrease in Touch or Pain or loss of Proprioception, alone or combined in 1 or 2 limbs; or moderate decrease in Touch or Pain and/or severe Proprioceptive decrease in more than two limbs
    5 - Loss of Sensation in 1 or 2 limbs; or moderate decrease in Touch or Pain and/or loss of Proprioception for most of the body below the head
    6 - Sensation essentially lost below the head
    V - Unknown

  5. Bowel and Bladder Function
    0 - Normal
    1 - Mild Urinary Hesitancy, Urgency, or Retention
    2 - Moderate Hesitancy, Urgency, or Retention of Bowel or Bladder, or rare Urinary InContinence
    3 - Frequent Urinary InContinence
    4 - Almost constant Cathaterization.
    5 - Loss of Bladder function
    6 - Loss of Bowel function
    V - Unknown

  6. Visual Function
    0 - Normal
    1 - Scotoma with Visual Acuity > 20/30 (corrected)
    2 - Worse Eye with Scotoma with maximal Acuity 20/30 to 20/59
    3 - Worse Eye with large Scotoma or decrease in fields, Acuity 20/60 to 20/99
    4 - Marked decrease in fields, Acuity 20/100 to 20/200; grade 3 plus maximal Acuity of better Eye < 20/60
    5 - Worse Eye Acuity < 20/200; grade 4 plus better Eye Acuity < 20/60
    V - Unknown

  7. Cerebral Function
    0 - Normal
    1 - Mood alteration
    2 - Mild decrease in Mentation
    3 - Moderate decrease in Mentation
    4 - Marked decrease in Mentation
    5 - Dementia
    V - Unknown

  8. Other Function
    0 - Normal
    1 - Other Neurological finding


Medical Texts
Anatomy | Immune System | Lymphocytes | Meds
MHC | Movement | Cranial Nerves | Physiology


MS Glossary ThJuland's MSers' Glen - Our CyberHome Page Top The Glen's Gallery: Come & Share Our Stories MS Files MS Abstracts Site Index


Abstracts
ANS | Bladder | Cognition | Fatigue | Fluid | Genetics
Interferons | IVIG | Nitric Oxide | Optic Neuritis | Pain
Physiology | Prions | Prognosis | ReMyelinate | Steroids
Stress | Treatments | TNF | Uric Acid | Viruses



© Copyright 1997 - 2009:
Permission is granted to MS Societies and all MSers to utilize information from these pages provided that no financial reward is gained and attribution is given to the author/s.