The 7 Differences between Multiple Sclerosis and ALS

Summary of the main differences between Amyotrophic Lateral Sclerosis and Multiple Sclerosis.

On more than one occasion we have heard of multiple sclerosis and amyotrophic lateral sclerosis. Although their names are different, as they share the word "sclerosis", there are those who confuse them or think that they must have the same symptoms.

In reality, they are two different neurological diseases, with different progression, treatments, symptoms and life expectancy, as well as involving a varying degree of involvement.

We will now discover what are the main differences between multiple sclerosis and ALS..

Main differences between Multiple Sclerosis and Amyotrophic Lateral Sclerosis

There are two neurological diseases whose name suggests that they are related and, indeed, they are. However, both have their particularities that not only affect the symptoms manifested by those who suffer from them, but also their treatment, progression and life expectancy. These diseases are multiple sclerosis and amyotrophic lateral sclerosis.

Before looking at the main differences between these two types of sclerosis, a brief and quick description of both is in order. Multiple Sclerosis (MS) is an autoimmune disease that affects the central nervous system, i.e. the spinal cord and brain, while Amyotrophic Lateral Sclerosis (ALS) is a degenerative neuromuscular disease in which motor neurons are destroyed.

As can be seen, both diseases involve alterations at the neurological level.But how it happens, what causes it and how it affects the patient's life is what differentiates the two medical conditions. Below we will find out what are the differences between multiple sclerosis and ALS.

1. Symptomatology

The first thing in which we observe differences are the symptoms of these two neurological diseases. At first, their symptomatology is similarThey share several symptoms of which we can highlight:

• Muscle weakness and stiffness
• Difficulty in moving the extremities
• Motor incoordination

However, as the disease progresses, we can find several symptoms that can help to see if it is a case of MS or ALS.

Patients with MS present with motor, sensory and cerebellar symptoms.. The first outbreaks of this disease are characterized by mobility problems, with tingling, walking difficulties and ataxia.

As the disease worsens, there are emotional and cognitive symptoms in the form of anxiety attacks, depression and memory problems, along with more physical problems such as fatigue, visual disturbances, spasms and problems moving arms and legs.

In contrast, cognitive symptoms do not usually occur in ALS, but there are many motor problems, which lead to decreased control which cause the patient's control of voluntary movements to progressively diminish. The patient loses strength in the arms and legs and, in the later stages of the disease, difficulties in speaking, swallowing and breathing appear.

2. Causes

MS and ALS are also differentiated by the causes that are believed to trigger them.

The exact cause of MS is not known with certainty, although it is known to be an autoimmune disease which may provide some clues. It has been theorized that the culprit for this neurological condition could be some pathogen, such as a virus, which would cause 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 it is known that its effects are different since the attack does not occur in the myelin but in the motor neurons.. Motor neurons are the cells responsible for controlling voluntary movements and, when they are attacked in the course of ALS, their death leads to muscular amyotrophy as they are unable to transmit the nerve impulse to the muscles.

3. Incidence of these two diseases

Another difference is the incidence of these two diseases, multiple sclerosis being more frequent than amyotrophic lateral sclerosis.

In Spain there are about 47,000 cases of MS, while ALS accounts for about 4,000 in the same country. In Europe, MS has been diagnosed in about 700,000 people while ALS would affect about 50,000 families. The prevalence of MS is between 80 and 180 cases per 100,000, while that of ALS is about 2 to 5 cases per 100,000 inhabitants.

4. Age of onset and gender differences

Multiple sclerosis has a much younger age of onset than amyotrophic lateral sclerosis. MS appears between the ages of 20 and 40 years, with an average age of diagnosis of about 29 years, while ALS tends to appear later, with an average age of onset of about 30 years. ALS usually appears later, between the ages of 40 and 70.. Because of how early MS can appear, this disease is considered the second leading cause of non-traumatic disability in young people.

There are also gender differences in the likelihood of having 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 not known.

5. Heritability

Although it has not been proven that MS is hereditary, there is a greater possibility of suffering from this disease if you have a family member who has been diagnosed. Having a family member with MS is a risk factor for presenting it, especially if it is a first-degree relative such as parents or siblings.

The heritability of ALS, on the other hand, seems to be a little more proven, since it is known that 10% of the patients with ALS have a higher risk of developing the disease.It is known that 10% of the cases of this disease are linked to the mutation of a gene that is inherited from the parents.

6. Progression of the disease

About 85% of patients with multiple sclerosis have a relapsing-remitting course, with occasional flares that remit.with occasional flares that remit with periods of some recovery, either total or partial. The symptoms associated with each outbreak progress for periods ranging from 24 to 72 hours, but then stabilize. There are even cases of people who may go for years without a flare-up.

Up to 50% of MS patients may suffer from the so-called secondary progressive form of the disease, with a slow and insidious course.with a slow and insidious course about 10 to 15 years after the first symptoms have appeared. Fifteen percent of MS patients have the primary progressive form, which involves a slow and progressive worsening of the disease. Patients with MS can have a life expectancy similar to that of the general population, provided they receive adequate treatment to control the progression of the disease.

These particularities of MS differ greatly from ALS, since its course is always progressive, with no flare-ups followed by periods of stability. However, the speed of deterioration can vary greatly depending on the case. Because the worsening is constant, the life expectancy of ALS patients is about 3 to 5 years from the time of diagnosis, although there are cases of people who have exceeded that life expectancy as is the famous case of theoretical physicist and astrophysicist Stephen Hawking.

7. Treatments

As they are two different diseases, they also require different treatments. There is no cure for either MS or ALS, but there are treatments that alleviate symptoms and improve the quality of life of those affected.

Currently, effective treatments for MS have only been approved for people with the relapsing-remitting variety. For the primary progressive form of the same disease, there are no effective treatments.The possibility of using corticosteroids such as dexamethasone has been raised.

The drugs used for people with MS are usually interferons: Avonex, Betaferon and Rebif. Copaxone, Mitoxantrone (immunosuppressant) and Natalizumab (monoclonal antibody) are also used.

For ALS patients there is currently only one marketed drug available: Riluzole.. This is a glutamate blocker that prevents neurons from being destroyed by the action of this substance.

As for non-pharmacological treatments, such as psychotherapy, physiotherapy and speech therapy, there are also different options depending on the disease, the degree of deterioration of the patient and how fast the disease progresses.