Understanding Neurological Rating Scales
History of the EDSS
Today the EDSS is the gold standard for measuring impairment in MS.
Originally developed in 1955 by John Kurtzke1, the Disability Status Scale or DSS was divided into 10 steps, where zero indicated normal health and 10 was death from MS - an uncommon event. This scale was found to miss small changes in disease severity and, in 1983, was expanded to 20, by adding half steps between steps one to 10 - hence the Expanded Disability Status Scale.2
Other neurological rating scales have been suggested – partly additionally to the EDSS – such as:
- Scripps scale (or Neurological Rating Scale from the Scripps Clinic) by Sipe et al 3
- ISS (Illness Severity Scale) developed by Mickey et al 4
- or the CAMBS (Cambridge Multiple Sclerosis Basic Score) suggested by Mumford and Compston 5
The EDSS, however, is today the standard measurement in clinical practice and in trials.
References
1 Kurtzke JF. Rating neurologic impairment in multiple sclerosis: An expanded disability status scale (EDSS). Neurology 1983;33(11):1444-1452.
2 Sharrak B, Hughes RAC. Clinical scales for multiple sclerosis. Journal of the Neurological Sciences 1996;135:1-9.
3 Sipe JC, Knobler RL et al. A neurologic rating scale (NRS) for use in multiple sclerosis. Neurology 1984;34:1368-1372.
4 Mickey MR, Ellison GW, Myers LW. An illness severity score for multiple sclerosis. Neurology 1984 34: 1343-1347.
5 Mumford CJ, Compston A. Problems with rating scales for multiple sclerosis: a novel approach – the CAMBS score. Journal of Neurology 1993;240:209-215.
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