These two neurodegenerative diseases have distinct symptoms and causes.
Famous people such as Stephen Hawking and Stephen Hillenburg were diagnosed with ALS, and even a few years ago a campaign to make this disease visible and collect donations (ice bucket challenge) went viral.
As for MS, León Foucault, Miquel Martí i Pol and Jack Osbourne are some of the people who were diagnosed with this disease.
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What are Multiple Sclerosis and Amyotrophic Lateral Sclerosis?
Although their names have become popular, these two diseases that share a surname are usually confused and there are those who may believe that they are two different ways to refer to the same thing.
The truth is that amyotrophic lateral sclerosis and multiple sclerosis are two different diseases, almost as much as are two second cousins with the same surname.
They present different ways of manifesting, symptoms, evolution and there are even differences between gender. Let’s take a closer look at how different they are.
Main differences between Multiple Sclerosis and ALS
Although both diseases are neurodegenerative conditions, where the nervous system is affected and progressively becomes increasingly impaired, MS and ALS are very different.
1. Causes
For multiple sclerosis, it is not yet known exactly what causes it, although the idea has been raised that behind this disease is the action of an unknown virus or pathogen.
In multiple sclerosis, the immune system begins to attackmyelin, a substance that coats nerve fibers and protects them so that they can correctly transmit the nerve impulse. Other nerve cells, such as oligodendrocytes, also die.
Although amyotrophic lateral sclerosis shares with the other disease the fact that it is also not known exactly what causes it, the effects are different. In this case, motor neurons are attacked.
Motor neurons are neurons that are responsible for motor control. In this disease, these cells progressively die, producing muscular atrophy due to the fact that the nerve impulse cannot be transmitted to the muscles.
2. Symptoms
At the beginning of both diseases, they share some symptoms, such as muscle weakness and stiffness, motor incoordination and difficulty moving the limbs. However, as they evolve, they also differentiate e.
In the case of multiple sclerosis, the most frequent symptoms are visual disturbances, speech problems and tremors in the hands.
The first episodes of multiple sclerosis usually present with tingling, ataxia, and an unsteady gait. In addition, cognitive and emotional symptoms may occur, such as memory problems, anxiety, and depression . Thermal sensitivity is also increased.
In amyotrophic lateral sclerosis, as it is a purely motor disease, movements that are controlled voluntarily are affected.
Strength is lost to move arms and legs and later there are problems articulating words, swallowing and even breathing.
In the case of ALS, it is not common for patients to present cognitive problems . A clear example of this is the case of Stephen Hawking, who until the end of his life was able to develop complex theories about the universe.
3. Gender
The reason for this asymmetry in terms of the sex of those affected is not well understood, but multiple sclerosis is more common in women while lateral amyotrophic sclerosis occurs more in men .
4. Age
Multiple sclerosis can appear between the ages of 20 and 40 , with a mean age of 29 years.
On the other hand, amyotrophic lateral sclerosis can affect people who are between the ages of 40 and 70 .
5. Incidence
Multiple sclerosis is more common than amyotrophic lateral sclerosis .
In Spain there are about 4,000 people diagnosed with amyotrophic lateral sclerosis, while about 47,000 people have multiple sclerosis.
In the United States, about 20,000 people are diagnosed with amyotrophic lateral sclerosis, while about 400,000 have multiple sclerosis.
6. Heritability
Multiple sclerosis is not believed to be an inherited disease , however having a relative with this diagnosis is considered a risk factor, especially if it is a parent or sibling.
In the case of amyotrophic lateral sclerosis, about 10% of cases are linked to a mutation in a gene inherited directly from parents.
7. Disease progression
In the case of multiple sclerosis, it is estimated that 85% of those affected present the relapsing-remitting variety , presenting punctual outbreaks that later remit and allow a partial or total recovery. Neurological symptoms progress over periods of 24 to 72 hours and then stabilize.
50% of people with multiple sclerosis develop a slow and insidious progression after about 10-15 years, called secondary progressive form.
15% of cases of multiple sclerosis present the primary progressive form, which consists of a slow and progressive worsening.
In the case of amyotrophic lateral sclerosis, its course is always progressive , although the speed of this progression varies from one patient to another.
8. Mortality
Multiple sclerosis is not necessarily a fatal disease . Most patients diagnosed with this disease have a normal life expectancy.
In contrast, amyotrophic lateral sclerosis limits the life of the person who suffers from it, with a life expectancy of between three and five years after diagnosis.
9. Treatments
There is no treatment that cures either amyotrophic lateral sclerosis or multiple sclerosis , however some advances have been made that allow to improve in some way the quality of life of people diagnosed with either of these two diseases.
In the case of multiple sclerosis, there are medications that combat the symptoms of the disease and slow its progress.
It should be noted that to date, only effective treatments have been approved for the relapsing-remitting variety of multiple sclerosis.
Three interferons (Avonex, Betaferon, and Rebif) are used in the treatment of multiple sclerosis, Copaxone, which is a set of polypeptides, Mitoxantrone, which is an immunosuppressant, and Natalizumab, a monoclonal antibody.
There are no effective treatments for primary progressive multiple sclerosis , although it has been hypothesized that corticosteroids such as dexamethasone at high doses every three months have some effect.
Physiotherapy , occupational therapy and speech therapy are used to treat the symptoms of both variants of multiple sclerosis , in addition to requiring neuropsychologists to evaluate cognitive deficits.
For amyotrophic lateral sclerosis there is only one drug marketed that is used in the treatment: Riluzole. This drug is a glutamate blocker, preventing neurons from becoming intoxicated and dying from this substance.
Physical therapy is a good tool to work on the symptomscaused by amyotrophic lateral sclerosis.
References
- Kinsley, L., and Siddique, T. (2001) Amyotrophic Lateral Sclerosis Overview. GeneReviews. 1-27
- Compston, To.; Coles, A. (2008). Multiple sclerosis. The Lancet, 372(9648): 1502-1517
- Rubin, S.M. (2013). Management of multiple sclerosis: an overview. Dis Mon.; 59(7):253-260
To the classic question “what do you do?” I always answer “basically I am a psychologist”. In fact, my academic training has revolved around the psychology of development, education and community, a field of study influenced my volunteer activities, as well as my first work experiences in personal services.
