0 - normal.
1 - disc pallor and / or small scotoma and / or visual acuity (corrected) of worse eye
less than 20 / 20 (1.0) but better than 20 / 30 (0.67).
2 - worse eye with maximal visual acuity (corrected) of 20 / 30 to 20 / 59 (0.67-0.34).
3 - worse eye with large scotoma and/or moderate decrease in fields and/or maximal
visual acuity (corrected) of 20 / 60 to 20 / 99 (0.33-0.21).
4 - worse eye with marked decrease of fields and/or maximal visual acuity (corrected)
of 20 / 100 to 20 / 200 (0.2-0.1); grade 3 plus maximal acuity of better eye of 20 / 60 (0.33) or less.
5 - worse eye with maximal visual acuity (corrected) less than 20 / 200 (0.1);
grade 4 plus maximal acuity of better eye of 20 / 60 (0.33) or less.
6 - grade 5 plus maximal visual acuity of better eye of 20 / 60 (0.33) or less.
BRAINSTEM FUNCTIONAL SYSTEM SCORE
0 - normal.
1 - signs only.
2 - moderate nystagmus and / or moderate EOM impairment and / or other mild disability.
3 - severe nystagmus and / or marked EOM impairment and / or moderate disability of other cranial nerves.
4 - marked dysarthria and / or other marked disability.
5 - inability to swallow or speak.
PIRAMIDAL FUNCTIONAL SYSTEM SCORE
0 - normal.
1 - abnormal signs without disability.
2 - minimal disability: patient complains of motor-fatigability or reduced performance in strenuous motor tasks (motor performance grade 1) and/or BMRC grade 4 in one or two muscle groups.
3 - mild to moderate paraparesis or hemiparesis: usually BMRC grade 4 in more than two muscle groups; and/or BMRC grade 3 in one or two muscle groups (movements against gravity are possible); and/or severe monoparesis: BMRC grade 2 or less in one muscle group.
4 - marked paraparesis or hemiparesis: usually BMRC grade 2 in two limbs or monoplegia with BMRC grade 0 or 1 in one limb; and/or moderate tetraparesis: BMRC grade 3 in three or more limbs.
5 - paraplegia: BMRC grade 0 or 1 in all muscle groups of the lower limbs; and/or marked tetraparesis: BMRC grade 2 or less in three or more limbs; and / or hemiplegia.
6 - tetraplegia: BMRC grade 0 or 1 in all muscle groups of the upper and lower limbs.
CEREBELLAR FUNCTIONAL SYSTEM SCORE
0 - normal.
1 - abnormal signs without disability.
2 - mild ataxia and/or moderate station ataxia (Romberg) and / or tandem walking not possible.
3 - moderate limb ataxia and / or moderate or severe gait/truncal ataxia.
4 - severe gait/truncal ataxia and severe ataxia in three or four limbs.<
5 - unable to perform coordinated movements due to ataxia.
X - pyramidal weakness (BMRC grade 3 or worse in limb strength) or sensory deficits interfere with cerebellar testing.
SENSORY FUNCTIONAL SYSTEM SCORE
0 - normal.
1 - mild vibration or figure-writing or temperature decrease only in one or two limbs.
2 - mild decrease in touch or pain or position sense or moderate decrease in vibration in one or two limbs; and/or mild vibration or figure-writing or temperature decrease alone in more than two limbs.
3 - moderate decrease in touch or pain or position sense or marked reduction of vibration in one or two limbs; and/or mild decrease in touch or pain or moderate decrease in all proprioceptive tests in more than two limbs.
4 - marked decrease in touch or pain in one or two limbs; and/or moderate decrease in touch or pain and/or marked reduction of proprioception in more than two limbs.
5 - loss (essentially) of sensation in one or two limbs; and/or moderate decrease in touch or pain and / or marked reduction of proprioception for most of the body below the head.
6 - sensation essentially lost below the head.
BOWEL AND BLADDER FUNCTIONAL SYSTEM SCORE
0 - normal.
1 - mild urinary hesitancy, urgency and / or constipation.
2 - moderate urinary hesitancy/retention and / or moderate urinary urgency/incontinence and /or moderate bowel disfunction.
3 - frequent urinary incontinence or intermittent self-catheterisation; needs enemata or manual measures to evacuate bowels.
4 - in need of almost constant catheterisation.
5 - loss of bladder or bowel function; external or indwelling catheter.
6 - loss of bowel and bladder function.
CEREBRAL FUNCTIONAL SYSTEM SCORE
0 - normal.
1 - signs only in decrease in mentation; mild fatigue.
2 - mild decrease in mentation; moderate or severe fatigue.
3 - moderate decrease in mentation.
4 - marked decrease in mentation.
5 - dementia.
AMBULATION SCORE
0 - unrestricted.
1 - fully ambulatory.
2 - ≥ 300 meters, but < 500 meters, without help or assistance (EDSS 4.5 or 5.0).
3 - ≥ 200 meters, but < 300 meters, without help or assistance (EDSS 5.0).
4 - ≥ 100 meters, but < 200 meters, without help or assistance (EDSS 5.5).
5 - walking range < 100 meters without assistance (EDSS 6.0).
6 - unilateral assistance, ≥ 50 meters (EDSS 6.0).
7 - bilateral assistance, ≥ 120 meters (EDSS 6.0).
8 - unilateral assistance, < 50 meters (EDSS 6.5).
9 - bilateral assistance, ≥ 5 meters, but < 120 meters (EDSS 6.5).
10 - uses wheelchair without help; unable to walk 5 meters even with aid, essentially restricted to wheelchair; wheels self and transfers alone; up and about in wheelchair some 12 hours a day (EDSS 7.0).
11 - uses wheelchair with help; unable to take more than a few steps; restricted to wheelchair; may need some help in transferring and in wheeling self (EDSS 7.5).
12 - essentially restricted to bed or chair or perambulated in wheelchair, but out of bed most of day; retains many self-care functions; generally has effective use of arms (EDSS 8.0).
13 - essentially restricted to bed much of the day; has some effective use of arm(s); retains some self-care functions (EDSS 8.5).
14 - helpless bed patient; can communicate and eat (EDSS 9.0).
15 - totally helpless bed patient; unable to communicate effectively or eat/swallow (EDSS 9.5).
