Multiple sclerosis and amyotrophic lateral sclerosis, or ALS, can be terrifying diagnoses, and since there are cures for neither, they are both life-altering conditions. Patients will be monitored and treated by multiple health care professionals throughout the course of their lives, and changes will be made to accommodate symptoms that occur based on the diseases.
In some cases, MS and ALS may be mistaken for each other, since there are many similarities between the diseases. However, because the prognosis and treatment options are not the same, it is crucial to follow through with all the necessary tests in order to pinpoint which is actually the ailment affecting the patient.
What is ALS?
ALS is a progressive disease of the central nervous system, which means it directly affects the brain, the spinal cord, and in some cases, the optic nerve. In this disease, the nerves that are targeted are in the lateral area of the spinal cord, which is where the nerves that signal muscle motion and control are. As these nerves start to degenerate with the disease, they scar and harden (sclerosis).
This hardening and degeneration, which lead to the death of neurons, causes the inability for electrical signals to reach peripheral nerves and the muscles they control. Progressively, the ability to control motion entirely is lost, starting with voluntary motion such as swallowing and walking and then moving to involuntary motion, such as breathing. ALS is a progressive disease, as well as a fatal one, eventually leading to death.
Symptoms and similarities
When compared to each other, ALS and MS do have some similarities that can make them easy to confuse, in the beginning stages. Perhaps more than many other diseases, ALS mirrors some aspects of MS because it also attacks the central nervous system, though in a very different way. But both lead to “sclerosis”, or the hardening and stiffening of the nerves.
Some of the symptoms that may confuse the two and lead to a need for further testing include:
- Difficulty walking and with mobility
- Weakness, especially in the limbs and extremities
- Muscle cramps or twitching muscles
- Slurred speech
- Difficulty swallowing
- Tripping and falling due to balance issues or weakness
Conditions and differences
The initial noticeable difference between multiple sclerosis and ALS is the onset. With MS, patients tend to experience a sudden onset of symptoms that can be mild or debilitating, all at once. After a few days to a week, those symptoms subside. However, with ALS, the onset is slow and building, which means that most patients don’t even notice the change at first and miss the signs until there is serious damage. But this is not the only difference.
- The reason for degeneration of the nerves in MS is an autoimmune reaction that causes the body to attack and destroy the myelin (a protective coating on the central nervous system that speeds up the impulse delivery) that is crucial. In ALS, the nerves simply degenerate, with a new study showing this could be partially due to the body’s inability to dispose of damaged protein in the nerves and, therefore, can’t halt or repair damage to the nerves caused by these proteins.
- Areas of the central nervous system (CNS) damaged in MS are random and cannot be predicted, which leads to the differences from one patient to another and the progression of the disease. With ALS, while there is some randomization of effect, all the damage is contained to motor control areas, mainly in the brain and the lumbar region of the spinal cord.
- Many people with multiple sclerosis have relapsing-remitting MS, meaning that symptoms come and go, partially due to the way attacks or flare ups occur and partially due to the fact that not all symptoms are due to irreparable damage but also can be caused by extreme inflammation that occurs with the disease. However, ALS patients don’t see much reverting or relief of symptoms, and, as the disease progresses, these symptoms tend to worsen quickly.
- Most patients diagnosed with multiple sclerosis are between the ages of 18 and 40, though this is by no means exclusive of others. In ALS, the majority of cases are diagnosed in people between the ages of forty and seventy, though again, there is no limitations on the possibilities.
- With MS, women are almost three times as likely as men to develop the disease, whereas prior to the age of 70, men are at slightly greater risk than women for ALS.
- Military veterans, for reasons unknown, have twice as high a rate as the general population of ALS. There is no correlation with MS.
- Both diseases have hereditary risk factors, though they are far different from each other. Someone with an immediate family member who has multiple sclerosis is twice as likely to develop it. This is not the case with ALS. In this case, only less than 10 percent of cases are hereditary. For someone who has a parent that develops ALS, there is a 50 percent chance of inheriting the disease.
- While both diseases are progressive and degenerative, multiple sclerosis is not typically fatal. However, ALS is a fatal disease that has an average lifespan of three to five years after diagnosis.
Both ALS and multiple sclerosis are serious diseases, and they are frightening to discover for a patient. However, early detection is the key to the best treatment options and the best possibility of slowing advancement of the disease and controlling symptoms. With the right medical advice and the right attitude, patients can overcome a great deal in either condition. Stephen Hawking lived over fifty years with ALS, and many people live full, healthy lives with MS. Neither of them has to be a prison sentence.