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Medical News Today: MS vs. ALS: Differences, causes, and treatment

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Medical News Today: MS vs. ALS: Differences, causes, and treatment,

MNT Knowledge Center
Multiple sclerosis and amyotrophic lateral sclerosis are both progressive diseases that affect the central nervous system.

Though the diseases are similar in some of their effects and symptoms, the treatment and outlook for each disease are very different.

This article looks at the key differences between the two conditions to help people better understand them.

Exploring how the conditions differ can empower those who may be experiencing symptoms to seek the treatment they need.

What is MS?

diagram of the brain and spine
Multiple sclerosis is a progressive condition that affects the brain, spinal column, and optic nerves.

Multiple sclerosis, commonly known as MS, causes the body’s immune system to attack the central nervous system. The central nervous system is made up of:

  • the brain
  • spinal cord
  • optic nerves

In MS, the immune system attacks myelin, which is a fatty substance that surrounds and insulates the nerve fibers. The damaged myelin forms scar tissue, called sclerosis.

This condition means that nerve impulses can be distorted or interrupted as they travel to and from the brain and spinal cord. This happens if part of the nerve fiber that these impulses travel in, or the surrounding myelin, is damaged or destroyed. The interruption produces a wide variety of symptoms.

Experts believe MS is triggered in genetically susceptible individuals when one or more environmental factors are present. People with MS may have a mild, moderate, or severe version of the condition.

What is ALS?

Amyotrophic lateral sclerosis (ALS) is commonly known as Lou Gehrig’s Disease and is a progressive neurological disease. The condition affects muscle movement by preventing the nerves that control these movements from working properly.

As time progresses, the dysfunctional nerves cause muscle weakness. The weakened muscles gradually cause paralysis.

The later stages of ALS may affect breathing and other crucial bodily functions, which can result in death. This is because the nerves that control these functions are badly affected by the condition.

Differences between MS and ALS

Both MS and ALS are neurodegenerative diseases that affect the central nervous system, namely the brain and spinal cord.

In many cases, the two diseases have similar symptoms, such as muscle weakness and paralysis. Unfortunately, neither disease has a cure, but they can both be managed.

Despite a number of similarities, there are some important distinctions between the two diseases.

For example, ALS is more common in men and occurs anywhere between the ages of 4 and 70. By contrast, MS is more common in women and typically occurs between the ages of 20 and 50.

Some additional, basic differences between the two diseases include:

  • ALS often causes paralysis, while MS can, but does not always, cause complete debilitation.
  • ALS is mainly physical, while MS also causes mental problems, such as memory loss.
  • ALS is not an autoimmune disease. By contrast, experts believe many forms of MS are autoimmune.

The following table summarizes some of the basic differences between the two diseases.

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

Causes

3 generations of a family
Whilst there is no conclusive evidence currently, studies suggest that genetics may be involved in the cause of both MS and ALS.

While the cause of MS is still unknown, researchers believe the interaction of several different factors may be involved.

These include:

  • immunological
  • environmental
  • infectious
  • genetic

Studies are ongoing in the areas of:

  • the body’s immune system
  • patterns of disease in the population
  • genetics

Researchers are also studying infectious agents, as these factors may play a role in MS as well.

Similarly to MS, ALS presents as a mystery to most researchers. This is because most cases of ALS present no clear cause. In a few cases, however, scientists can point to specific factors that may make a person more likely to develop ALS, such as genetics.

Symptoms

MS symptoms are unpredictable, can vary between people, and can change over time. In fact, people rarely have exactly the same symptoms. One person might experience only one or two symptoms, while another person experiences three or more.

Some symptoms of MS include:

  • fatigue
  • walking difficulties
  • vision problems
  • numbness or tingling
  • bladder or bowel problems
  • cognitive changes
  • pain
  • depression
  • sexual problems
  • vertigo

ALS symptoms often vary greatly between people with the disease. ALS is characterized by gradual onset and painless, progressive muscle weakness. Once started, however, ALS can take as little as 3 years to significantly affect a person.

Symptoms of ALS can begin in the muscles that control speech and swallowing. In other cases, ALS symptoms may start in the hands, arms, legs or feet. However, progressive muscle weakness and paralysis are universally experienced.

Other symptoms of ALS include:

  • tripping
  • abnormal fatigue of the arms and/or legs
  • slurred speech
  • uncontrollable periods of laughing or crying
  • dropping objects
  • muscle cramps and twitches

In more advanced cases, the respiratory muscles become affected. People with ALS will eventually need permanent ventilatory support, which assists with breathing.

Treatment

Physical therapy
Physical therapy may be used to treat the signs and symptoms of MS and to improve the quality of life for people with ALS.

While research is ongoing, neither disease currently has a cure. Each disease has a component in treatment designed to slow progression and manage symptoms.

Typical MS treatments include:

  • Treating attacks: Using corticosteroids (to reduce nerve inflammation) and plasma exchange (mixing plasma with a protein solution).
  • Treating disease progression: Using treatments, such as disease modifying drugs, which vary greatly in their side effects and overall effectiveness.
  • Treating signs and symptoms of MS: Options include physical therapy, muscle relaxers, and medications to reduce fatigue.

In contrast, ALS treatments may include:

  • Medication targeting progression: Riluzole is currently the only approved drug.
  • Treatments easing symptoms.
  • Treatments designed to improve quality of life: These include physical and speech therapies, use of feeding tubes and ventilators, and occupational therapy.

Although Riluzole is the only drug currently approved to target the progression of ALS, a new form of this drug has recently been approved for clinical trial by the U.S. Food and Drug Administration (FDA).

Treatment similarities and differences are summarized in the table below:

MSALS
Medicationocrelizumab, glatiramer acetate, Dimethyl fumarate, beta interferons, fingolimod, mitoxantrone, alemtuzumab, natalizumab, teriflunomideriluzole
TherapiesPhysicalPhysical, occupational, and speech
Lifestyle changesImprove diet, exerciseImprove diet and exercise (early stages)
Symptoms and treatmentMedication to reduce fatigue, muscle relaxantsMedications to help reduce fatigue, pain, ease muscle cramps, control spasticity, and reduce excess saliva and phlegm. Therapies and medicines to combat depression, pain, and sleep issues.

Outlook

Though many symptoms and signs of MS and ALS appear similar, the two diseases have unique characteristics that separate them from each other.

While neither MS or ALS has a known cure or definitive cause, the outlook for each condition differs.

Both diseases are degenerative and see a slow progression of symptoms and issues increasing over time. However, MS is not fatal, whereas ALS may eventually lead to death due to respiratory failure.

Thankfully, there are many treatment options in place to improve the quality of life of those who are affected by these conditions.

Moreover, the future is promising as both diseases are heavily researched. Researchers are hopeful to gain some answers to the causes, prevention, and eventual cure of each condition.

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