Multiple sclerosis (MS) is an autoimmune disease that affects the brain and spinal cord, in other words, the central nervous system (CNS). Therefore, it’s a neurological disease. Furthermore, it affects millions of people around the world. However, amyotrophic lateral sclerosis (from now on, ALS) is a degenerative disease of the neuromuscular type, in which the motor neurons are destroyed. Its incidence is four cases per 100,000 people per year.

Both are neurological diseases. Nevertheless, there are differences between multiple sclerosis and ALS. We talk about them below.

The differences between multiple sclerosis and ALS

There appear to be many differences between multiple sclerosis and ALS. In this article, we mention eight, although there may be some more.

Symptoms

Although shared symptoms may appear at the onset of both diseases (muscle weakness and stiffness, difficulty in moving the limbs, motor incoordination, etc), the reality is that the symptoms differ significantly as each of the diseases progresses.

When multiple sclerosis first appears, sufferers usually experience the following symptoms: tingling, unsteady gait, and ataxia. As the disease progresses, emotional and cognitive manifestations appear (anxiety, depression, and memory disorders). These symptoms might vary greatly from one patient to another.

In the case of ALS, symptoms don’t usually appear at a cognitive level. On the other hand, many motor symptoms do appear. These progressively decrease the control of voluntary movements. Patients also lose strength in their arms and legs. In the final stages of the disease, they also experience difficulties in speaking, swallowing, and breathing.

Causes

Each of the conditions appears to have a different cause. In the case of multiple sclerosis, its exact cause isn’t known. However, it’s recognized as an autoimmune disease.

There’s also mention of the possible action of an unknown virus or pathogen, which may cause the immune system to start attacking the myelin. This is the substance that covers and protects the nerve fibers of the nervous system. On the other hand, oligodendrocytes, another type of nerve cell, are also destroyed.

In the case of ALS, its cause also isn’t known. However, its effects are different, since the attack doesn’t occur on the myelin but on the motor neurons. These cells are in charge of controlling voluntary movements. In ALS, the final stages of the disease lead to muscle amyotrophy, as the nerve impulses can’t be transmitted to the muscles of the body.

Incidence

There’s a difference in the incidences of multiple sclerosis and ALS. In the US, about 400,000 people suffer from multiple sclerosis, compared to 20,000 who have ALS. Thus, multiple sclerosis is more common than ALS.

Age of onset and gender

Multiple sclerosis usually appears much earlier than ALS. Its age of onset is usually between 20 to 40 years of age. The average age for its development is 29.  However, ALS, usually appears later, between the ages of 40 and 70.

Regarding gender, multiple sclerosis is more common in women than in men, while ALS appears more in men. The reason? It’s not known exactly why.

Heritability

It hasn’t been proven that multiple sclerosis is hereditary. Nevertheless, it’s known that having a relative with the same disease is a risk factor for suffering from it, especially with first-degree relatives, such as parents or siblings.

In the case of ALS, ten percent of cases are known to be linked to a mutation of a gene that’s inherited from the parents.

Treatments

Another difference between the two diseases is their treatments. Although there’s no treatment that cures either of the conditions, there are treatments that improve symptoms and the quality of life of patients.

In multiple sclerosis, effective treatments have so far only been approved in people with the relapsing-remitting variety. In the primary-progressive variety, there are no effective treatments. However, treatment is being hypothesized with corticosteroids such as dexamethasone.

Regarding the treatments that have shown efficacy, three interferons are usually used: Avonex, Betaferon, and Rebif. Copaxone (set of polypeptides), Mitoxantrone (immunosuppressant), and Natalizumab (monoclonal antibody) are also used.

In the case of ALS, there’s currently only one commercialized drug. This is Riluzole. It consists of a glutamate blocker that prevents neurons from being destroyed by this substance. In relation to other types of treatments (psychological, physiotherapeutic, speech therapy), there are different options for both diseases.

Disease progression

How does each of these diseases run its particular course? Is this another one of the differences between multiple sclerosis and ALS?  The answer is yes. In fact, 85 percent of patients with multiple sclerosis have a relapsing-remitting course (with specific outbreaks that remit, allowing some [total or partial] recovery).

The symptoms that appear in each outbreak progress for periods ranging from 24 to 72 hours, but then stabilize. Nevertheless, it’s worth mentioning here that there are people who can go years without suffering outbreaks.

On the other hand, up to 50 percent of patients with multiple sclerosis suffer the so-called “secondary progressive form of the disease”, with a slow and insidious course after ten-15 years. Finally, 15 percent of cases present the so-called “primary-progressive form”, which implies a slow and progressive worsening of the disease.

However, this differs greatly in the case of ALS, since its course is always progressive (not like multiple sclerosis, in which flare-ups appear). However, the speed of this worsening can vary greatly from one person to another.

Mortality and severity

If we look at the symptoms and mortality associated with ALS, as compared with multiple sclerosis, we can say that ALS is much more serious. In fact, a sufferer’s life expectancy tends to be only three-five years after diagnosis. However, this isn’t always the case. You only have to look at Stephen Hawking, for instance.

In the case of multiple sclerosis, this isn’t necessarily a fatal disease, although many patients often see their quality of life greatly diminished. However, their life expectancy is normal.

Different diseases, different realities

Multiple sclerosis and ALS are totally different diseases, even though they both affect the central nervous system (CNS). However, the reality of each one and even more so, the reality of each person who lives with them, differs markedly. Knowing the difference between them is imperative, particularly if you know a sufferer and want to help.

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