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Neurology Service, Veterans Administration Medical Center and Departments of Neurology and of Community Medicine, Georgetown University School of Medicine, Washington, DC.
One method of evaluating the degree of neurologic impairment in MS has been the combination of grades (0 = normal to 5 or 6 = maximal impairment) within 8 Functional Systems (FS) and an overall Disability Status Scale (DSS) that had steps from 0 (normal) to 10 (death due to MS). A new Expanded Disability Status Scale (EDSS) is presented, with each of the former steps (1,2,3 ... 9) now divided into two (1.0, 1.5, 2.0 ... 9.5). The lower portion is obligatorily defined by Functional System grades. The FS are Pyramidal, Cerebellar, Brain Stem, Sensory, Bowel & Bladder, Visual, Cerebral, and Other; the Sensory and Bowel & Bladder Systems have been revised. Patterns of FS and relations of FS by type and grade to the DSS are demonstrated.
Address correspondence and reprint requests to Dr. Kurtzke, Chief, Neurology Service (127), Veterans Administration Medical Center, 50 Irving Street, NW, Washington, DC 20422.
Accepted for publication February 9, 1983.
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