Table of ContentsView AllTable of ContentsSymptoms of MS vs. ALSCausesDiagnosis of MS vs. ALSTreatmentSummary
Table of ContentsView All
View All
Table of Contents
Symptoms of MS vs. ALS
Causes
Diagnosis of MS vs. ALS
Treatment
Summary
Multiple sclerosis (MS)andamyotrophiclateral sclerosis (ALS)are lifelong neurological diseases associated with muscle weakness and physical disability. MS is related to an immune system attack on nerve coverings. ALS weakens muscles and its cause is unknown.
MS and ALS share some similar symptoms. Neither condition is curable, but MS is not life-threatening and may not impact life expectancy.ALS (also known as Lou Gehrig’s disease), on the other hand, requires major life-sustaining interventions and is eventually fatal.
This article looks at symptoms, causes, diagnosis, and treatment options in MS vs. ALS.
Neurological symptoms are the hallmark of both MS and ALS. Still, while there are a few overlaps in symptoms, there are major differences.
Ellen Lindner / Verywell
Muscle weakness or trouble speaking (dysarthria) or swallowing (dysphagia) are among the first symptoms of ALS.In contrast, the first symptoms of MS are oftenparesthesias(numbness or tingling in extremities) or vision changes.
Either of these conditions can begin with mild problems, such as twitching of the hand, or a major event, such as leg weakness and a sudden fall.
Muscle Weakness in Arms and Legs
ALS always advances to cause muscle paralysis (complete weakness). The muscles eventually atrophy (shrink and deteriorate). Eventually, everyone who has ALS will need an assistive device, such as a walker, wheelchair, or scooter.
Many people with MS experience mild or moderate muscle weakness, but only rarely experience paralysis. MS can affect your walking, and you may need anassistive deviceto get around, but most people with MS have more independence than those with ALS.
Trouble Speaking
Dysarthria is common in ALS and MS. Dysarthria does not affect your understanding of words because it is not a language disorder. Your speech may be hard to understand, and you might also drool, especially when speaking.
Generally, dysarthria is more severe with ALS than with MS.
Cognitive Issues
MS can producecognitive dysfunction, which often manifests as clouded thinking or slowed thinking. This can be intermittent or can progress throughout the disease course.
ALS can also have cognitive and behavioral dysfunction that is worse with advancing disease, but not as common when compared to MS patients.
Mood or Personality Changes
MS may producemoodand personality changes due to its direct effect on the brain.
ALS can also be associated with depression, anxiety, and personality changes, but these tend to be less common than in patients with MS.
Swallowing Problems
ALS commonly produces dysphagia. This will often progress to the point that afeeding tubeor othermeans of nutritionis needed.
While MS-related swallowing problems can occur too, they are usually less severe and can typically be managed with swallowing therapy and dietary adjustments.
Breathing Problems
ALS usually causes impaired breathing due to degeneration of the nerves that power the respiratory muscles. Most people with ALS need a device to help with breathing, often starting withnoninvasive ventilation(a mask that delivers oxygen). They later progress to mechanical ventilation, which uses a powered machine to support lung function.
Breathing problems rarely occur in MS and are usually mild. Likewise, it is rare forMS-related respiratory problemsto require breathing assistance.
Vision Changes
ALS does not affect vision, but it can cause altered eye movements late in the course of the disease.
Sensory Symptoms
Sensory changes are common in MS and can manifest with a range of unpleasant sensations, such asnumbness and tinglingorpain.
Some people with ALS report tingling sensations. However, this is not common and it usually goes away.
Bladder and Bowel Symptoms
It is estimated that over 90% of people who have MS experiencebladder dysfunction, including the inability to initiate urination and/or incontinence.People who have ALS can lose motor control and may experience bowel and bladder incontinence.
MS and ALS are both commonly associated withconstipation.
MS, but not ALS, can also involve the optic nerves (the nerves that control vision).
MS is three times more common in women, while ALS tends to affect men and women equally.
In addition, the disease pathophysiology (biological changes) of the two conditions is completely different.
Why Do People Develop MS?
Myelin is regularly replaced, and you can recover from an MS relapse without any residual effects. Sometimes, though, nerve damage or scarring can occur, and the neurological deficit can be long lasting or permanent.
Myelin Sheath Function and Purpose
Why Do People Develop ALS?
With ALS, themotor neurons and tracts located in the brain, brainstem, and spinal cord are gradually damaged, causing muscle weakness and atrophy (shrinkage).
ALS is not believed to have an autoimmune cause, but it isn’t clear exactly why the disease occurs.
A physical examination can show some overlapping features in MS and ALS. For example:
With MS, you can have altered sensation anywhere on your body (although you might not), but your sensory examination should be normal with ALS.
Because of this, testing is needed. You may have some of the same diagnostic tests if you have either of these two conditions, but the results will be completely different.
Testing and Imaging
Alumbar puncture (spinal tap)will show a characteristic pattern with MS that is not seen with ALS.
Steps to Getting an MS Diagnosis
Both diseases are treated with disease-modifying therapy; other treatments and strategies are used to minimize health complications.
Disease-Modifying Therapy
Disease-modifying therapies(DMTs) are taken on a regular basis to prevent exacerbations and overall neurological decline in MS. Other treatments, including corticosteroids, are used specifically to treat an MS exacerbation.
How Multiple Sclerosis Is Treated
Disease Management
With both of these conditions, support for medical complications and disabilities is a major part of medical care.
For example, you may benefit from physical therapy to optimize your swallowing and motor control. A supportive brace can help you walk or use your hands and arms. Prevention ofbed sores, respiratory infections, and malnutrition is important, and strategies related to these issues may be worked into your care over time.
Adapting to bladder and bowel issues may be necessary, and medications used to prevent painful spasms may be helpful.
MS and ALS are both neurological diseases and share some similar symptoms. They also have some distinct differences. One very significant difference is the prognosis: MS is rarely fatal, while ALS is a terminal illness.
10 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Multiple Sclerosis Association of America.Multiple sclerosis introduction.ALS Association.Living with ALS: Resource guide.National Institute of Neurological Disorders and Stroke.Motor neuron disease.ALS Association.ALS symptoms and diagnosis.Multiple Sclerosis Association of America.MS symptom listing.Multiple Sclerosis Association of America.Types of multiple sclerosis.National Institute on Neurological Disorders and Stroke.Amyotrophic lateral sclerosis.Aharony SM, Lam O, Corcos J.Evaluation of lower urinary tract symptoms in multiple sclerosis patients: Review of the literature and current guidelines.Can Urol Assoc J. 2017 Jan-Feb;11(1-2):61-64. doi:10.5489/cuaj.4058National Multiple Sclerosis Society.Who gets multiple sclerosis?Cruz MP.Edaravone (Radicava): A novel neuroprotective agent for the treatment of amyotrophic lateral sclerosis.P T. 2018;43(1):25-28.Additional ReadingDattola V, Famà F, Russo M, Calabrò RS, Logiudice AL, Grasso MG et al.Multiple sclerosis and amyotrophic lateral sclerosis: A human leukocyte antigen challenge.Neurol Sci. 2017;38(8):1501-1503. doi:10.1007/s10072-017-2939-0Johnsen B, Pugdahl K, Fuglsang-Frederiksen A, Kollewe K, Paracka L, Dengler R et al.Diagnostic criteria for amyotrophic lateral sclerosis: A multicentre study of inter-rater variation and sensitivity.Clin Neurophysiol.2019;130(2):307-314. doi:10.1016/j.clinph.2018.11.021
10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Multiple Sclerosis Association of America.Multiple sclerosis introduction.ALS Association.Living with ALS: Resource guide.National Institute of Neurological Disorders and Stroke.Motor neuron disease.ALS Association.ALS symptoms and diagnosis.Multiple Sclerosis Association of America.MS symptom listing.Multiple Sclerosis Association of America.Types of multiple sclerosis.National Institute on Neurological Disorders and Stroke.Amyotrophic lateral sclerosis.Aharony SM, Lam O, Corcos J.Evaluation of lower urinary tract symptoms in multiple sclerosis patients: Review of the literature and current guidelines.Can Urol Assoc J. 2017 Jan-Feb;11(1-2):61-64. doi:10.5489/cuaj.4058National Multiple Sclerosis Society.Who gets multiple sclerosis?Cruz MP.Edaravone (Radicava): A novel neuroprotective agent for the treatment of amyotrophic lateral sclerosis.P T. 2018;43(1):25-28.Additional ReadingDattola V, Famà F, Russo M, Calabrò RS, Logiudice AL, Grasso MG et al.Multiple sclerosis and amyotrophic lateral sclerosis: A human leukocyte antigen challenge.Neurol Sci. 2017;38(8):1501-1503. doi:10.1007/s10072-017-2939-0Johnsen B, Pugdahl K, Fuglsang-Frederiksen A, Kollewe K, Paracka L, Dengler R et al.Diagnostic criteria for amyotrophic lateral sclerosis: A multicentre study of inter-rater variation and sensitivity.Clin Neurophysiol.2019;130(2):307-314. doi:10.1016/j.clinph.2018.11.021
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Multiple Sclerosis Association of America.Multiple sclerosis introduction.ALS Association.Living with ALS: Resource guide.National Institute of Neurological Disorders and Stroke.Motor neuron disease.ALS Association.ALS symptoms and diagnosis.Multiple Sclerosis Association of America.MS symptom listing.Multiple Sclerosis Association of America.Types of multiple sclerosis.National Institute on Neurological Disorders and Stroke.Amyotrophic lateral sclerosis.Aharony SM, Lam O, Corcos J.Evaluation of lower urinary tract symptoms in multiple sclerosis patients: Review of the literature and current guidelines.Can Urol Assoc J. 2017 Jan-Feb;11(1-2):61-64. doi:10.5489/cuaj.4058National Multiple Sclerosis Society.Who gets multiple sclerosis?Cruz MP.Edaravone (Radicava): A novel neuroprotective agent for the treatment of amyotrophic lateral sclerosis.P T. 2018;43(1):25-28.
Multiple Sclerosis Association of America.Multiple sclerosis introduction.
ALS Association.Living with ALS: Resource guide.
National Institute of Neurological Disorders and Stroke.Motor neuron disease.
ALS Association.ALS symptoms and diagnosis.
Multiple Sclerosis Association of America.MS symptom listing.
Multiple Sclerosis Association of America.Types of multiple sclerosis.
National Institute on Neurological Disorders and Stroke.Amyotrophic lateral sclerosis.
Aharony SM, Lam O, Corcos J.Evaluation of lower urinary tract symptoms in multiple sclerosis patients: Review of the literature and current guidelines.Can Urol Assoc J. 2017 Jan-Feb;11(1-2):61-64. doi:10.5489/cuaj.4058
National Multiple Sclerosis Society.Who gets multiple sclerosis?
Cruz MP.Edaravone (Radicava): A novel neuroprotective agent for the treatment of amyotrophic lateral sclerosis.P T. 2018;43(1):25-28.
Dattola V, Famà F, Russo M, Calabrò RS, Logiudice AL, Grasso MG et al.Multiple sclerosis and amyotrophic lateral sclerosis: A human leukocyte antigen challenge.Neurol Sci. 2017;38(8):1501-1503. doi:10.1007/s10072-017-2939-0Johnsen B, Pugdahl K, Fuglsang-Frederiksen A, Kollewe K, Paracka L, Dengler R et al.Diagnostic criteria for amyotrophic lateral sclerosis: A multicentre study of inter-rater variation and sensitivity.Clin Neurophysiol.2019;130(2):307-314. doi:10.1016/j.clinph.2018.11.021
Dattola V, Famà F, Russo M, Calabrò RS, Logiudice AL, Grasso MG et al.Multiple sclerosis and amyotrophic lateral sclerosis: A human leukocyte antigen challenge.Neurol Sci. 2017;38(8):1501-1503. doi:10.1007/s10072-017-2939-0
Johnsen B, Pugdahl K, Fuglsang-Frederiksen A, Kollewe K, Paracka L, Dengler R et al.Diagnostic criteria for amyotrophic lateral sclerosis: A multicentre study of inter-rater variation and sensitivity.Clin Neurophysiol.
2019;130(2):307-314. doi:10.1016/j.clinph.2018.11.021
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