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What are ALS and MS?
Overview about ALS
Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease, is a progressive neurodegenerative disease that affects nerve cells in the brain and the spinal cord.
Motor neurons reach from the brain to the spinal cord and from the spinal cord to the muscles throughout the body. The progressive degeneration of the motor neurons in ALS eventually leads to their death. When the motor neurons die, the ability of the brain to initiate and control muscle movement is lost. With voluntary muscle action progressively affected, patients in the later stages of the disease may become totally paralyzed.
There is no cure for ALS and no effective treatment to halt, or reverse, the progression of the disease. ALS can strike anyone. Presently there is no known cause for the vast majority of ALS cases, although research has shown that there are a number of genetic and environmental factors that appear to play a role in its development.
Overview about MS
Multiple sclerosis (MS) is a neurodegenerative disease that affects the brain and spinal cord. MS causes the immune system to attack the myelin sheath, which is the protective covering around nerve cells. The damage to the myelin sheath causes communication problems between your brain and the rest of your body.
MS can cause a wide range of symptoms, including changes in sensation, visual problems, muscle weakness, depression, difficulties with coordination and speech, severe fatigue, cognitive impairment and bladder and bowel difficulties. The course of MS is unpredictable, ranging from relatively benign to somewhat disabling to devastating as communication between the brain and other parts of the body is disrupted. Most people with MS have a normal or near-normal life expectancy.
MS affects women more than men. It usually begins between the ages of 20 and 40; however, an increasing number of younger children are being diagnosed with a childhood form of MS.
There’s no cure for multiple sclerosis. However, treatments can help speed recovery from attacks, modify the course of the disease and manage MS symptoms.
What are the symptoms of ALS and MS?
ALS and MS have many symptoms in common, which is why they’re often confused.
The most common symptoms of ALS include:
- Muscle weakness progression
- Muscle cramps and twitching (fasciculations)
- Difficulty speaking or swallowing (dysphagia)
- Breathing problems (respiratory difficulties)
The most common symptoms of MS include:
- Numbness or tingling in the face, body, or extremities (arms and legs)
- Weakness in one or more limbs that occurs on one side of the body at a time or the bottom half of the body at a time
- Electric-shock sensations that occur with certain head movements, especially bending the neck forward (Lhermitte sign)
How do ALS and MS affect you mentally?
If you or someone close to you has been diagnosed with multiple sclerosis (MS) or amyotrophic lateral sclerosis (ALS, also known as Lou Gehrig’s disease), you may be wondering how the condition will affect your ability to function in everyday life.
People with MS often experience changes in their mental health, such as mood swings, depression, and problems thinking and remembering. These symptoms can vary in frequency. Some people have them only once in a while, while others have them all the time.
I have MND, not MS or ALS. However, I don’t think the disease itself affects your mental health.
I would say that my mental health is actually pretty good, mostly because of my wife. She is my primary carer and does a lot to make sure I am comfortable.
It’s not all easy though, and there are times when things get tough. I do see a counsellor every couple of months just to talk about how life has changed for me, and how it has affected other aspects of my life.
Another thing that helps is having hobbies. I used to be a very active person. Now I can’t do as much as I used to, but I’ve found new hobbies that keep me busy.
I suppose the biggest effect on my mental health was the first few weeks after diagnosis. It was a very bleak time; however my family helped me through it.
How do ALS and MS affect the immune system?
The immune system is made up of a large number of cells that act together to protect the body from viruses and bacteria. The job of the immune cells is to recognize foreign invaders, such as bacteria and viruses, and destroy them. There are many different types of immune cells and each type has a special function.
There are two main components of the immune system: innate immunity and acquired immunity. Innate immunity includes physical barriers (such as skin) that work to prevent infection, as well as special white blood cells that identify and kill foreign invaders. Acquired immunity involves T-cells, B-cells and antibodies that work together to fight specific infections.
In MS there is evidence that B-cells are overactive. This leads to production of antibodies that attack myelin, which is the protective coating surrounding nerve fibers in the brain and spinal cord. In ALS evidence suggests that the innate immune system is overactive, which leads to nerve cell death.
How are ALS and MS diagnosed?
The diagnosis of ALS and MS can be challenging since the initial symptoms may mimic those of other disorders. There are no specific diagnostic tests for either disorder, but there are several diagnostic procedures that can help exclude other neurological diseases and support a diagnosis of ALS or MS.
Diagnostic procedures may include:
Physical examination: Your health care provider will perform a physical examination and ask about your medical history and symptoms. He or she will also perform a neurological examination to assess muscle strength, reflexes, coordination, speech, vision and sensation.
Blood tests: Blood tests may be used to rule out other disorders that have similar symptoms to ALS or MS.
Spinal tap (lumbar puncture): A small amount of cerebrospinal fluid is removed from your spine for testing. The cerebrospinal fluid can be tested for inflammation, antibodies, the presence of oligoclonal bands or increased levels of protein — all of which can suggest MS. In addition, your doctor might send the cerebrospinal fluid to a lab where it is cultured to see if any bacteria or viruses grow out in it.
No single test can confirm the diagnosis of ALS or MS. Instead, your doctor will review your medical history, ask about your signs and symptoms, and conduct a neurological examination. Your doctor may order tests to rule out other conditions that may be causing your symptoms.
How are ALS and MS treated?
There is no cure for ALS or MS. But there are medicines that may help you feel better and live longer.
Treatment options include:
- Medicines. Medicines can treat pain, spasms, bladder problems, and depression.
- Occupational therapy teaches you how to take care of yourself, which may include changing your eating habits and learning how to get dressed.
- Physical therapy helps with balance and strength.
- Surgery can be done on people with MS if they have severe muscle spasms in the lower back (called lumbar spasm).
- Speech therapy can teach you ways to talk and swallow if your muscles involved in such tasks weaken or stop working.
There are treatments available to improve the quality of life of those with ALS and MS. Each condition has specific treatment options, but many people with one of these conditions also use complementary therapies.