More than once we have heard of multiple sclerosis and amyotrophic lateral sclerosis. Although their name is different, as they share that of “sclerosis”, there are those who confuse them or think they must have the same symptoms.
They are in fact two different neurological diseases, with different course, treatments, symptoms and life expectancy, in addition to involving a varying degree of impairment.
Below we will find out what they are the main differences between multiple sclerosis and ALS.
Main differences between multiple sclerosis and amyotrophic lateral sclerosis
There are two neurological diseases whose names suggest they are related and, indeed, they are. However, both have their peculiarities which affect not only the symptoms manifested by those who suffer from them, but also in their treatment, progression and life expectancy. These diseases are multiple sclerosis and amyotrophic lateral sclerosis.
Before examining the main differences between these two types of sclerosis, it is worth giving a brief and rapid description. Multiple sclerosis (MS) is an autoimmune disease that affects the central nervous system, i.e. the spinal cord and the brain, while amyotrophic lateral sclerosis (ALS) is a degenerative neuromuscular disease in which motor neurons are destroyed.
As you can see, both diseases involve neurological alterations, but the way it is administered, what causes it and how it affects the life of the patient is what differentiates the two medical conditions. Next, we’ll find out what the differences are between multiple sclerosis and ALS.
The first thing we notice about the differences are the symptoms of these two neurological diseases. At first her symptoms are similar, sharing several symptoms of which we can highlight:
- Muscle weakness and stiffness
- Difficulty moving limbs
- Motor incoordination
However, as the disease progresses we may find several symptoms that can help to see if it is a case of MS or ALS.
Patients with MS have motor, sensory, and cerebellar symptoms. The first foci of this disease are characterized by mobility problems, tingling, difficulty walking and ataxia.
As the disease worsens, emotional and cognitive symptoms present in the form of anxiety attacks, depression and memory problems, as well as more physical problems such as fatigue, visual disturbances. , spasms and difficulty moving the arms and legs.
However, cognitive symptoms do not usually occur in ALS, but many motor problems do occur that cause a progressive decrease in the control of voluntary movements of the affected person. The patient loses strength in the arms and legs, and in the later stages of the disease, difficulties appear in speaking, swallowing and breathing.
MS and ALS are also differentiated by the causes thought to cause them.
It is not known for sure what the exact cause of MS is, although it is an autoimmune disease that may give some clues. It has been speculated that the cause of this neurological disease could be a pathogen, such as a virus, which causes the immune system to start attacking myelin and oligodendrocytes. Myelin is the substance that protects nerve fibers, while oligodendrocytes are a type of nerve cell.
The exact cause of ALS is also not known, but its effects are known to be different like the attack does not occur in myelin but in motor neurons. Motor neurons are the cells responsible for controlling voluntary movements and, when attacked in ALS, their death ends up causing muscle atrophy by not being able to transmit nerve impulses to the muscles.
3. Incidence of these two diseases
Another difference is the incidence of these two diseases, with multiple sclerosis being more common than amyotrophic lateral sclerosis.
In Spain there are around 47,000 cases of MS, while ALS is around 4,000 in the same country. In Europe, MS has been diagnosed in around 700,000 people while ALS is believed to affect around 50,000 families. The prevalence of MS is between 80 and 180 cases per 100,000 population, while ALS is approximately 2 to 5 cases per 100,000 population.
4. Age of onset and gender differences
Multiple sclerosis is much earlier than amyotrophic lateral sclerosis. MS appears between 20 and 40 years old, with an average age of diagnosis of around 29 years, while ALS usually appears later, between the ages of 40 and 70. Due to the early onset of MS, this disease is considered the second leading cause of non-traumatic disability in young people.
There are also gender differences in the likelihood of suffering from one or the other. MS is more common in women than in men, while ALS occurs more in men than in women. The exact reason why there are gender differences in the occurrence of these diseases is unknown.
Although MS has not been shown to be inherited, there is a greater chance of suffering from this condition if you have a relative who has been diagnosed. Having a family member with MS is a risk factor for having it, especially if it’s a first-degree relative or sibling.
The heritability of ALS, on the other hand, seems a little more proven, because we know that 10% of cases of this disease are linked to the mutation of a gene inherited from the parents.
6. Progression of the disease
About 85% of patients with multiple sclerosis have a relapsing-remitting course, with occasional epidemics that leave periods with some recovery, total or partial. Symptoms associated with each outbreak progressed over periods ranging from 24 to 72 hours, but then stabilized. There are even cases of people who can be years without showing epidemics.
Up to 50% of MS patients may suffer from the so-called progressive secondary form of the disease, with a slow and insidious course after about 10 or 15 years of having exhibited the first symptoms. 15% of patients with MS have the primary progressive form, which implies a slow and progressive worsening of the disease. Patients with MS may have a life expectancy similar to that of the general population, provided they receive appropriate treatment to monitor the progression of the disease.
These peculiarities of MS differ greatly from ALS in that the course is always gradual, without flare-ups followed by periods of stability. However, the rate of deterioration can vary considerably from case to case. As the worsening is constant, the life expectancy of patients with ALS is approximately 3 to 5 years from the time of diagnosis, although there are cases of people who have exceeded this expectation of life like the famous case of theoretical physicist and astrophysicist Stephen. Peddling.
Because they are two different diseases, they also require different treatments. There is no cure for MS or ALS, but there are treatments that relieve symptoms and improve the quality of life for people with it.
Currently, effective treatments for MS have only been approved in people with the relapsing form. For the primary progressive variety of the same disease, there are no effective treatments, although the possibility of using corticosteroids such as dexamethasone has been considered.
Medicines used for people with MS are usually interferons: Avonex, Betaferon and Rebif. Copaxone, Mitoxantrone (immunosuppressant) and Natalizumab (monoclonal antibody) are also used.
For patients with ALS, currently, only one marketed drug is available: Riluzole. It is a glutamate blocker that prevents neurons from being destroyed by the action of this substance.
When it comes to non-pharmacological treatments, such as psychotherapy, physiotherapy, and speech therapy, there are also different options depending on the disease, the degree of the patient’s aggravation, and how quickly their disease progresses.
- Kinsley, L. and Siddique, T. (2001) Overview of amyotrophic lateral sclerosis. GeneReviews, 1-27
- Compston, A .; Coles, A. (2008). Multiple sclerosis. The Lancet, 372 (9648): 1502-1517.
- Rubin, SM (2013). Management of Multiple Sclerosis: An Overview. Say Mon .; 59 (7): 253-260.