What EDSS score and relapse rate mean for people with MS

Your neurologist uses a variety of different markers to see whether your MS is progressing and whether your treatment is working. Some of these markers measure your symptoms and ability to function. Two key markers are your EDSS score and your relapse rate.

Disability level (measured by EDSS score)

EDSS, which stands for Expanded Disability Status Scale, measures your overall level of disability on a scale of 0 to 10:


What it means

0 No disability, normal neurological exam
1 No disability, minor changes on neurological exam
2 Minimal disability
3 Moderate disability
4 Relatively severe disability but still able to be up and about for up to 12 hours a day and walk without a cane
5 Disability severe enough to affect daily routine
6 Needs a cane to walk, needs assistance to work
7 Restricted to wheelchair
8 Restricted to bed or wheelchair
9 Confined to bed
10 Death due to MS

Relapse rate

Your neurologist will calculate your "relapse rate" by measuring the number of relapses (periods of time where symptoms suddenly get worse or new symptoms suddenly appear) that you have over time. A higher relapse rate in the first 2 years of the disease increases your risk of progression.

What can I do?

Early treatment with disease-modifying medications can help reduce the frequency and severity of relapses and slow the progression of disability. There may be a "window of opportunity" early in the disease, where effective treatment has the greatest possible impact on slowing down the progression of MS.

  • Talk to your neurologist to make sure you are on optimal treatment so that you don't miss this window of opportunity. Use the Treatment Check-Up to help you decide if it's time to see your neurologist about your treatment.
  • Learn more about your MS treatment options.

Understanding MRI changes: brain lesions and brain atrophy

During your check-up, your neurologist will ask about your symptoms and your ability to function. But that's just one piece of the puzzle. Even when you are not having symptoms, MS may be causing silent damage to your brain that can increase your risk of progression later on.

An MRI (magnetic resonance imaging) scan can help show this hidden damage and monitor the course of MS. Markers that can show up on an MRI scan include brain lesions and brain atrophy.

Brain lesions (damaged areas)

Brain lesions are areas of the brain that have been damaged by inflammation related to MS.

Brain atrophy (shrinkage)

Brain atrophy is another word for brain shrinkage caused by MS. People with brain atrophy may be more likely to have MS-related cognitive problems. Brain atrophy can happen early in the disease and damage can be happening even when a person has no symptoms.

What can I do?

  • Take the Treatment Check-Up to find out if it's time to talk to your neurologist about optimal treatment.
  • Learn more about your MS treatment options.
  • Take an active role in your treatment even when you're not having symptoms, since MS may still be silently damaging your brain.