Functional systems (FS)

Description

Score

Pyramidal

Normal

0

Abnormal signs without disability

1

Minimal disability

2

Mild or moderate paraparesis or hemiparesis; severe monoparesis

3

Marked paraparesis or hemiparesis; moderate quadriparesis; or monoplegia

4

Paraplegia, hemiplegia, or marked quadriparesis

5

Quadriplegia

6

Cerebellar

Normal

0

Abnormal signs without disability

1

Mild ataxia

2

Moderate truncal or limb ataxia

3

Severe ataxia, all limbs

4

Unable to perform coordinated movements due to ataxia

5

Brainstem

Normal

0

Signs only

1

Moderate nystagmus or other mild disability

2

Severe nystagmus, marked extraocular weakness, or moderate disability of other cranial nerves

3

Marked dysarthria or other marked disability

4

Inability to swallow or speak

5

Sensory

Normal

0

Vibration or figure-writing decrease only, in 1 - 2 limbs

1

Mild decrease in touch, pain or position sense, and/or moderate decrease in vibration in 1 - 2 limbs; or vibratory decrease alone in 3 - 4 limbs

2

Moderate decrease in touch, pain or position sense, and/or lost vibration in 1 - 2 limbs; or mild decrease in touch, pain and/or moderate decrease in all proprioceptive tests in 3 - 4 limbs

3

Marked decrease in touch or pain or loss of proprioception, alone or combined, in 1 - 2 limbs; or moderate decrease in touch, pain and/or severe proprioceptive decrease in >2 limbs

4

Loss of sensation in 1 - 2 limbs; or moderate decrease in touch, pain and/or loss of proprioception for most of the body below the head

5

Sensation essentially lost below the head

6

Bowel and bladder

Normal

0

Mild urinary hesitancy, urgency, or retention

1

Moderate hesitancy, urgency, retention of bowel or bladder, or rare urinary incontinence

2

Frequent urinary incontinence

3

In need of almost constant catheterization

4

Loss of bladder function

5

Loss of bowel and bladder function

6