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Birds of a Feather: Differentiating Between MS and Als

Dr. Zahid Rustam

2 min read

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Multiple Sclerosis (MS) and Amyotrophic Lateral Sclerosis (ALS) are both neurodegenerative conditions with similar goals: to affect and damage the brain, spinal cord, nerves, and muscles, which is why they are so commonly mistaken for one another. Consult a neurologist for an effective Multiple Sclerosis amangement plan.

However, these conditions that appear so similar on the surface are actually two vastly different entities, with their most distinctive deviations being:

1-The Cause:

  • MS is an autoimmune disorder in which the immune system mistakenly attacks the protective coverings of the nerves, or myelin sheath, in the brain and spinal cord. One theory for these immune system misfires is that iron deposits that form in the brain due to narrow or deformed veins cause myelin inflammation and the resultant MS symptoms.
  • ALS is a nervous system disorder that targets the motor neurons responsible for voluntary actions in the brain and spinal cord.


  • MS is commonly induced by environmental factors, although people with a close relative, i.e. mother, father, brother or sister, affected with the condition are at higher risk of MS.
  • ALS is significantly genetic, with 10% of all global cases being inherited directly from parents. However, it can also occur spontaneously with no known trigger or precedent.


  • MS affects younger people between 20-50, with only a few cases of later age diagnosis.
  • ALS is commonly diagnosed in people between 40-70, with the average age at the time of diagnosis being 55. However, the condition can be diagnosed at an earlier age.

4-Sclerotic Differences:

While both conditions cause the scarring and hardening of nerve cells (sclerosis),

  • MS directly attacks and damages the myelin sheath. Known as demyelination, this process disrupts brain/body communication by interrupting the signals sent from the brain to the body.
  • ALS hardens the myelin sheath by damaging and destroying motor neurons in the brain and spinal cord. This cuts off communication between the nerves and muscles in a particular area, resulting in gradual muscle atrophy (wasting).


  • MS progression is unpredictable and varies from person to person. Symptoms may only be mild for the most part and never lead to disability, or progress rapidly and lead to complete loss of function. They may also disappear for months or years at a time in some cases.
  • ALS has a distinct, painless onset pattern that starts either with muscle weakening in the arms and legs, or throat and mouth, and gradually spreads to the entire body staring from one side.

6-Later Stages:

  • Movement is highly affected in the later stages of MS, although it rarely ever culminates in complete paralysis.
  • Patients become completely paralyzed in later ALS stages. Along with the inability to move, common symptoms include slurred speech, trouble breathing and swallowing, and shortness of breath.

7-Affected Functions:


  • MS equally affects voluntary nerves in the entire body. Along with nerves responsible for movement, sensory nerves (sight, smell, taste, and touch), and nerves that control the bladder, and temperature sensitivity are also affected.
  • ALS only affects movement-related muscles, particularly those in the arms, legs, mouth, and throat.


  • MS causes severe mental and emotional changes. These include mood swings, depression, a reduced focusing ability, inability to multitask, memory problems, and even dementia.
  • ALS does not usually affect mental ability. However, a small percentage may experience mild-to-moderate cognitive disabilities in later stages. Some may even develop Frontotemporal Dementia that affects decision-making, behavioral control, emotion, and language.


Despite garnering more public attention through awareness campaigns like the Ice Bucket Challenge, MS is diagnosed in more people worldwide than ALS.


  • MS is not fatal. Most patients live a normal or near-normal lifespan as compared to the average non-MS individual.
  • ALS is eventually fatal, with the average life expectancy being 3-5 years following diagnosis.

Although incurable, recent medical advances have helped increase the life expectancy and improve life quality by slowing down disease progression. If you or someone you love suffers from either one of the conditions, consult with your doctor to co-develop a comprehensive treatment plan. You can also book an appointment with a top Neurologist in Lahore, Karachi and Islamabad through oladoc.com, or call our helpline at 042-3890-0939 for assistance to find the RIGHT Doctor for your neural concerns.

Disclaimer: The contents of this article are intended to raise awareness about common health issues and should not be viewed as sound medical advice for your specific condition. You should always consult with a licensed medical practitioner prior to following any suggestions outlined in this article or adopting any treatment protocol based on the contents of this article.

Dr. Zahid Rustam
Dr. Zahid Rustam - Author Dr. Zahid Rustam is among the Best Rehab Medicines in Islamabad. Dr. Zahid Rustam completed his MBBS from Army Medical College and pursued his further education in the UK and USA. Recently, Dr. Zahid has Earned qualification of FIPP WIP USA which is the only recognised Post graduation degree in Interventional pain practice. He is one of only 6 physician in pakistan to earn this Degree.

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