What are the differences between MS and ALS?

Multiple sclerosis and amyotrophic lateral sclerosis are both chronic disorders affecting the central nervous system, and affecting the ability of a person to conduct their everyday tasks.

Both conditions can have similar effects and symptoms but treatment and outlook are different.

This article addresses the similarities and distinctions between multiple sclerosis (MS) and lateral amyotrophic sclerosis (ALS).

What is MS?

Most people with MS will have a normal lifespan, and symptoms may not be present all the time.
Most people with MS will have a normal lifespan, and symptoms may not be present all the time.

In MS, the body’s immune system mistakenly attacks myelin, the substance in the central nervous system ( CNS) which protects the nerves. That results in myelin sheath damage and scarring.

That can lead to nerve impulses being interrupted or distorted as they pass between the brain and the spinal cord. These adjustments can lead to a vast array of symptoms.

These signs can have varying impacts. A individual may experience a worsening of symptoms for a while during remitting-relapsing MS (RRMS), then make a partial or complete recovery.

However, the symptoms tend to return.

In progressive forms of MS, the symptoms do not go away but gradually worsen.

Symptoms may be mild, extreme or moderate. Some people will finally lose their walking and talking skills, but that’s uncommon. MS normally does not impact life expectancy.

What is ALS?

ALS is a chronic neurologic disorder, or Lou Gehrig ‘s disease. It prevents proper functioning of the nerves which control muscle movement.

In time, nerve damage contributes to muscle weakness and finally to paralysis.

ALS impacts breathing in its late stages, and that can make it life-threatening.

Differences between MS and ALS

Both MS and ALS are CNS-affecting neurodegenerative diseases. According to the National Multiple Sclerosis Society, MS is more common , affecting up to 1 million adults in the United States.

The National Institute of Neurological Disorders and Stroke (NINDS) estimates it affects about 250,000–350,000 individuals, although they say the exact figure is hard to tell.

According to the NINDS, approximately 14,000–15,000 U.S. individuals may be living with ALS.

Symptoms which overlap include muscle weakness and paralysis. There is no remedy for either disorder at this time, but the effects of both can be treated. In the case of MS, there are now therapies which can avoid flares and delay the disease progression.

MS and ALS vary in several significant respects, however.

Who do MS and ALS affect?

ALS is more popular in men by 20 percent. It most likely starts at age 55–75, but it can occur at any age.

MS is more common in women and usually occurs at 20–50 years of age, but can occur at any age as well.

Other basic differences include:

  • ALS often causes paralysis. This is rare with MS.
  • ALS mainly affects physical functions, while MS can lead to problems with memory and thinking.
  • ALS is not an autoimmune disease, but MS probably results from a faulty immune reaction.

The following table summarizes some of the other differences between the two conditions.

MSALS
Autoimmune diseaseYesNo
Most affected genderFemaleMale
Age range20–5040–70
Physical symptomsYesYes
Mental symptomsYesNo
May lead to deathNoYes
Has a cureNoNo

Causes

MS and ALS seem to have different causes which we will discuss in the following sections in more detail.

MS

Experts aren’t sure exactly why MS is growing. Some people may have genetic factors which increase the risk of it occurring when there are also certain environmental factors.

The following may play a role:

  • Immunological factors: There may be a link with other autoimmune conditions.
  • Environmental triggers: Smoking, having low vitamin D levels, and living in a colder climate are common factors.
  • Infectious diseases: Certain viral infections may play a role.
  • Genetic factors: These might increase the risk.

ALS

Most ALS cases do not have a specific cause, although genetic factors do seem to play a role. Experts agree that about 60 percent of people with ALS have a genetic trait that results in symptom growth.

Veterans tend to be more likely to develop ALS, indicating that environmental factors may also play a role.

ALS does not appear to require an unusual development in the immune system.

Symptoms

MS and ALS symptoms can be similar but there are some major variations to remember.

MS

MS symptoms vary widely from person to person. They can also be unpredictable and can change over time. One person may live with mild symptoms for many years, while another may experience a loss of mobility.

Symptoms of MS include:

  • fatigue and weakness
  • difficulties with walking and balance
  • vision problems
  • pain, numbness, or tingling
  • bladder or bowel problems
  • changes in thinking and memory
  • pain
  • depression
  • sexual problems
  • dizziness and vertigo
  • itching

Symptoms may come and go in RRMS, the most frequent form of MS, during cycles of flare and recovery.

ALS

ALS symptoms can also vary widely. With ALS the muscles steadily and painlessly weaken. However, once ALS starts, it can take as little as 3 years to affect a person’s life significantly.

Symptoms of ALS may start in muscles controlling speech and swallowing. Symptoms may start with some people’s hands , arms , legs, or feet. But gradual muscle weakening and paralysis affect almost all with ALS over time.

Other symptoms of ALS include:

  • tripping when walking
  • abnormal fatigue of the arms, legs, or both
  • slurred speech
  • uncontrollable laughing or crying
  • dropping objects
  • muscle cramps and twitches

As ALS progresses, it can affect the muscles in the respiratory system , making breathing difficult. A individual may need to use a ventilator, for that purpose.

Experiencing remission is uncommon in a person with ALS.

Treatment

Currently there is no cure for either MS or ALS but medication is available to delay development and symptom control.

MS treatment options

Physical therapy can treat both ALS and MS.

For MS, the American Academy of Neurology recommendations suggest beginning from the early stages using a disease-modifying treatment. The medications are intended for normal use, whether there are signs or not.

These can reduce the risk of flares and may delay the condition ‘s progression. A individual should talk to his doctor about the best medicine for his or her situation.

Other treatment options may assist in managing flares and treating symptoms.

They include:

  • Corticosteroid injections: These reduce nerve inflammation, can reduce the impact of a flare, and help manage severe symptoms. A doctor will give these only when necessary.
  • Plasma exchange: This involves taking blood from the person’s body, removing certain substances from it, and returning it to the body. This is suitable for people with severe symptoms and when other medications do not help.
  • Lifestyle remedies: Exercising when possible, avoiding smoking, eating a healthful diet, and taking doctor-recommended supplements may help.
  • Physical therapy: Various types of therapy can help a person maintain strength and flexibility and find new ways to carry out tasks as their abilities change.
  • Other treatments: A doctor can recommend a variety of treatments for symptoms such as depression, constipation, pain, and itching, among others.

ALS treatment options

There are many forms of treatment available to delay the progression of the disease and to help a person control their symptoms. An individual may also wish to try various forms of therapy or make some changes in lifestyle:

  • Riluzole and Edaravone: Riluzole (Rilutek or Tiglutik) is a drug that may reduce damage to the muscles and nerves, but it cannot reverse the damage. Edaravone (Radicava) may slow the progression of ALS.
  • Other medications: Medications are available that can help reduce symptoms such as fatigue and pain, muscle cramps, spasms and involuntary displays of emotion, and excess saliva and phlegm.
  • Condition management strategies: Trying physical and speech therapies, assistive technology, feeding tubes, ventilators, and occupational therapy can help improve quality of life. Counseling may help with depression and sleep issues.

Outlook

MS and ALS have common symptoms but there are also major variations. The outlook is one big difference between the circumstances.

Both are disorders that are degenerative and can develop over time.

But a person with MS can live with only mild symptoms for several years. A person with MS will have roughly the same life expectancy as an individual without MS, according to the NINDS.

ALS, on the other hand, is more likely to develop quickly and become life-threatening because of its resulting respiratory failure. The life expectancy of a person with ALS is 2–5 years after diagnosis according to the ALS Association.

However, 50 percent of people with ALS will live after diagnosis for at least another 3 years, while 5 percent will live longer or more for 20 years.

Many treatment options and lifestyle changes can help improve a person’s quality of life with either MS or ALS, and ongoing studies may help improve future outlook.

Some scientists believe regenerative treatments such as stem cell therapy will reverse or repair neurological damage in time. That may mean a remedy for conditions like MS and ALS.

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