Multiple Sclerosis Vs ALS: A Comparison

If you’re experiencing symptoms like muscle spasms, fatigue, and trouble walking, it’s important to get a check-up as soon as possible. You might read online that your symptoms could fit either of two diagnoses – Multiple Sclerosis or Amyotrophic Lateral Sclerosis. And while on the surface they do have some features in common, ALS and MS actually are very different. Here, we offer a brief guide on the difference between ALS and MS so that you are well prepared for what to expect.

Understanding Multiple Sclerosis and Motor Neuron Disease

Amyotrophic Lateral Sclerosis is part of a category of conditions known as Motor Neuron Disease (MND). Motor Neuron Diseases are a group of neurodegenerative disorders that selectively affect motor neurons – cells that control all the voluntary muscles of the body. Amyotrophic Lateral Sclerosis is also known as Lou Gehrig’s Disease. The brain of the patient can no longer send messages to the muscles, causing them to weaken and eventually die. ALS is an inherited disease in about 5-10% of patients, and with unknown causes in the remaining cases. There is no cure, although treatment can slow its progression and improve overall functionality.

Multiple Sclerosis (MS) is a chronic inflammatory condition of the central nervous system. It is an autoimmune demyelinating disease, which means the immune system mistakenly attacks normal tissues — in this case, the myelin or protective covering around nerve fibers. This leaves scarred tissues or lesions in multiple areas, disrupting electrical impulses throughout the body. When the myelin sheath is damaged, nerve impulses slow down or even stop, causing neurological problems. The cause of Multiple Sclerosis is unknown in most cases, although genetic and environmental factors could play a role. Treatment can slow disease progression and manage symptoms so that patients live an almost normal lifespan. 

Similarities between Multiple Sclerosis and Motor Neuron Disease

When it comes to ALS vs MS, both diseases manifest in a somewhat similar fashion, which is why several people confuse them. Here’s what they have in common:

  • Both are chronic, degenerative conditions
  • Both affect the central nervous system and cause hardening or scarring around the nerve cells
  • Both affect muscles and limbs, thus causing problems with voluntary movement
  • Early symptoms for both conditions include fatigue, muscle spasms, tremors, and trouble walking
  • Diagnosis for both requires similar tests such as an MRI, a spinal tap, and tests of neurological function 
  • The exact cause for MS as well as ALS is unknown in most cases
  • A diagnosis for either condition will typically involve a process of elimination, which means ruling out other diseases that could be responsible for the symptoms
  • Both have no cure, but can be managed through a tailored treatment plan that includes Physical Therapy, Occupational Therapy, Speech Therapy, and Stem Cell Therapy

Difference between ALS and MS

ALS and MS differences far outnumber the similarities. This is because they are completely different conditions, with different origins and different rates of progression. We can discuss the differences as follows.

  • The key difference between ALS and MS is that Multiple Sclerosis is an autoimmune condition, while ALS is a neurodegenerative condition.
  • In Multiple Sclerosis, the disease affects the myelin sheaths in the central nervous system, thus disrupting the transmission of signals of the body. However, in ALS, the actual nerve cells are affected, which causes movement problems.
  • Multiple Sclerosis is not a hereditary disease. About 5% to 10% of ALS cases, however, are inherited.
  • MS mostly affects patients between the ages of 20 and 40, while ALS mostly affects those between the ages of 40 and 70. 
  • Multiple Sclerosis is a more common condition than ALS, which is classified as a rare disease.
  • MS occurs most commonly in women, whereas people of all genders can get ALS although the likelihood is slightly higher for men.
  • In addition to movement related symptoms, Multiple Sclerosis affects bladder control and cognitive ability, as well as the senses of sight, touch, and smell. AlS, however, causes only movement disorders, including problems with voluntary actions like breathing or eating.
  • The symptoms of MS tend to come and go in patterns of relapse and recovery. With ALS, the symptoms progressively worsen over time.
  • As Multiple Sclerosis progresses, cognitive decline is one of the key symptoms. It does not, however, appear in ALS.
  • Late-stage Multiple Sclerosis is rarely fatal in itself, although death can occur from related complications like breathing trouble or infected bedsores. Late-stage ALS, on the other hand, is highly debilitating and ultimately fatal, most often because of respiratory failure. 
  • Patients with Multiple Sclerosis tend to live an almost normal lifespan. Those with ALS usually survive five to 10 years after diagnosis, although some go on to live much longer.

FAQs

What are usually the first signs of ALS?

People with ALS may initially notice symptoms like muscle twitches or cramps, weakness in one arm or leg, or slurred speech.

Is MS more common than ALS?

ALS is regarded as a rare disease, with fewer than 20000 cases currently known. By contrast, about 2.5 million people worldwide are currently known to be living with Multiple Sclerosis.

Is MS linked to ALS?

Some research indicates that relatives of people with Multiple Sclerosis were significantly more likely to be diagnosed with ALS. This could indicate commonalities between the diseases, particularly given that both have an environmental and genetic component to them.

What does ALS feel like in the legs?

Characteristic symptoms of ALS include weakness, muscle cramps, or spasticity in the legs.

Can ALS be mistaken for MS?

It often happens that ALS is mistaken for Multiple Sclerosis, owing to the similarity in symptoms such as scarring around the nerve fibers, fatigue, muscle spasms, and trouble walking.

Can you have ALS and MS at the same time?

It is possible for a patient to have both ALS and MS, but it is extremely rare. 

Is tingling a symptom of ALS?

ALS does not cause symptoms like numbness, tingling, or loss of sensation.

How do I know I have ALS?

If you observe symptoms in yourself such as muscle weakness, slow or slurred speech, muscle twitches or muscle tightness, it may be a good idea to get a check up for ALS.

Is ALS always fatal?

ALS is a progressive disease and most patients survive two to five after the diagnosis. However, some may go on to live for decades after the diagnosis, such as the famous British physicist Stephen Hawking.

What part of the body does ALS affect first?

ALS tends to start in the limbs, feet, or hands before spreading to the rest of the body.

How fast is ALS progression?

While the individual rate of progression may differ, the median survival after diagnosis of ALS is about 5 years.

How fast do you lose weight with ALS?

ALS patients may lose up to 10% of their body weight in the first year after diagnosis. This is mainly on account of muscle wastage, as well as dysphagia (trouble swallowing). 

What is the most aggressive form of ALS?

The most aggressive type of ALS is bulbar ALS, which attacks the muscles used in swallowing, speaking, and breathing and is typically fatal within months.

What is the average lifespan of a person with ALS?

On average, a person can survive about two to five years after the ALS diagnosis, although many may go on to live for decades.

In short, if you find yourself asking ‘what is the difference between ALS and MS’, know that they are completely different conditions that require their own treatment approach. Living with either can be tough, but early diagnosis, a tailored treatment program, and the support of your loved ones will go a long way in helping you navigate the condition.

Dr Na'eem Sadiq is a respected stem cell specialist at Plexus, and a prominent neurologist in Bangalore. He studied neurology and clinical neurophysiology in London, and worked with some of the most prestigious medical institutions in England, and the Middle East. He completed his MBBS at Bellary Government Medical College, and a postgraduate degree in psychiatry from NIMHANS in Bangalore.

Dr Na'eem has perfected his knowledge and expertise in Continuing medical education (CME), and training in tissue culture, Stem Cell Therapy, and neurology. Dr Na'eem Sadiq possesses an undying passion to improve people’s lives. This led to the creation of Plexus, a neuro and Stem Cell Research centre in Bangalore in neurosurgery, and neurorehabilitation.