The key difference between ALS and MS is that Amyotrophic Lateral Sclerosis (ALS) is a specific disorder that involves the motor neuron degeneration or death of motor neurons while Multiple Sclerosis (MS) is a demyelinating disease where insulating covers of nerve cells in the brain and spinal cord are damaged.
What is ALS?
Amyotrophic Lateral Sclerosis (ALS), is also known as Lou Gehrig’s disease and Charcot disease, and it is caused by the degeneration of motor neurons. The symptoms of ALS include stiff muscles, muscle twitching, and progressive muscle wasting. This results in difficulty in speaking, swallowing, and eventually breathing due to the involvement of the relevant muscle groups.
The cause of ALS is not known in the majority of cases. A minority of cases are inherited from a person’s parents. ALS occurs due to the death of the neurons that control the voluntary muscles. The diagnosis of ALS is based on the signs and symptoms with other investigations done to rule out other potential causes.
This disorder causes degeneration of the upper and lower motor neurons. Symptoms and signs will depend on the sites of the neuronal involvement. However, bladder and bowel function and the muscles responsible for eye movements are spared until the later stages of the disorder.
Cognitive function is generally spared though a minority can develop dementia. Sensory nerves and the autonomic nervous system are usually unaffected. The majority of the patients with ALS die from respiratory failure, usually within three to five years from the onset of symptoms.
Management of ALS aims at relieving symptoms and extending life expectancy. Supportive care should be provided by the multidisciplinary teams of health care professionals. Treatment is mostly supportive with respiratory and feeding support. Riluzole has been found to effective in improving the survival modestly.
Stephen Hawking, a noted physicist suffering from ALS
What is MS (Multiple Sclerosis)?
This is also known as Disseminated Sclerosis or Encephalomyelitis Disseminate. Demyelination of the nerve fibers disrupts the ability of the affected part of the nervous system to communicate, resulting in a wide range of signs and symptoms, including physical, mental, and sometimes psychiatric problems. The signs and symptoms of MS include loss or changes in sensation such as tingling, pins and needles or numbness, muscle weakness, muscle spasms, difficulties with coordination and balance (ataxia); problems with speech or swallowing, visual problems etc. MS has several forms, with new symptoms either occurring in isolated episodes (relapsing forms) or building up over time (progressive forms). There are several forms based on the pattern of progression.
- Relapsing-remitting
- Secondary progressive (SPMS)
- Primary progressive (PPMS)
- Progressive relapsing.
The underlying mechanism is thought to be either destruction of the immune system or failure of the myelin-producing cells. genetics, and environmental factors (e.g. infections) can also affect this disease. Life expectancy of a patient diagnosed with MS is, on average, 5 to 10 years lower than that of an unaffected person.
Multiple sclerosis is typically diagnosed based on presenting clinical signs and symptoms, in combination with medical imaging and laboratory testing such as cerebrospinal fluid analysis and evoked potentials of the brain.
Treatment of MS depends on the pattern of involvement, and the treatment principle is immune modulation as this is mostly an immune-mediated disease. During symptomatic attacks, administration of high doses of IV corticosteroids, such as methylprednisolone, is the accepted therapy. Some other approved treatments include interferon beta-1a, interferon beta-1b, glatiramer acetate, mitoxantrone, etc.
What is the difference between ALS and MS?
Definition of ALS and MS
ALS: An incurable disease of unknown cause in which progressive degeneration of motor neurons in the brain stem and spinal cord leadsto atrophy and eventually complete paralysis of the voluntary muscles.
MS: A chronic autoimmune disease of the central nervous system in which gradual destruction of myelin occurs in patches throughout thebrain or spinal cord or both, interfering with the nerve pathways and causing muscular weakness, loss of coordination, and speech and visual disturbances.
Characteristics of ALS and MS
Pathology
ALS: ALS is mostly a neurodegenerative disorder.
MS: MS is a demyelinating disorder.
Cause
ALS: In ALS, genetics plays a role and majority of the cases the cause is unknown.
MS: In MS, the immune-mediated damage is well known.
Age Group
ALS: ALS generally affect elderly people.
MS: For MS, there is no age specification and seen among young and middle-aged population as well.
Neuronal Involvement
ALS: ALS, specifically, affects the motor system.
MS: MS can affect almost any part of the nervous system.
Symptoms
ALS: ALS manifest with motor symptoms.
MS: MS can manifest with ant neurological symptom.
Progression
ALS: ALS is always a progressive disease.
MS: MS can have progressive, relapsing, or mixed pattern.
Diagnosis
ALS: ALS diagnosis is based on the clinical signs and symptoms.
MS: MS diagnosis is based on clinical as well as important investigations.
Treatment principle
ALS: ALS treatment is mostly supportive.
MS: MS treatment is based on immune modulation.
Prognosis
ALS: In ALS, life expectancy is maximally 5 years.
MS: In MS, life expectancy is usually more than 5 years.
Image Courtesy:
“Symptoms of multiple sclerosis” by Mikael Häggström – All used images are in public domain. (Public Domain) via Commons
“Stephen hawking 2008 nasa” by NASA/Paul Alers – http://www.nasa.gov/50th/NASA_lecture_series/hawking.html. Licensed under (Public Domain) via Commons