How are MS vs. ALS diagnosed?
If the history, symptoms, and physical exam suggest that ALS is a possible diagnosis, the patient is usually referred to a neurologist and given an electromyogram (EMG) to test muscle and nerve function. If these functions are not normal, an MRI of the spinal cord and brain is typically ordered. Some patients will also have a spinal tap and blood tests to help exclude other diseases. The diagnosis of ALS is by exclusion. This means that ALS is diagnosed after other possible diseases have been ruled out. A neurology consultant specialist usually does this diagnosis.
The same methods are used to diagnose MS. Moreover, like ALS, multiple sclerosis is a diagnosis of exclusion (proving that other conditions are not the cause of symptoms). However, MS has two additional diagnostic components that most neurologists to diagnose MS. The first is evidence of damage in the central nervous system in two separate areas (for example, MRI findings of damage in the brain, spinal cord, and/or optic nerve), and the evidence that the damage occurred at two different points in time.
Treatments for ALS cannot reverse the nerve damage, but they can only slow progression of disease. The US FDA has approved two drugs for the treatment of ALS-riluzole (Rilutek) and edaravone (Radicava).
MS treatment is not a cure for multiple sclerosis. Treatments may help speed recovery from an MS exacerbation of symptoms and may slow the progression of the disease. Although a few patients may have mild symptoms, and not require treatment. Treatments for MS attacks can include corticosteroids and plasma exchange (plasmapheresis, in which the liquid portion of your blood is removed, treated, and returned to the body). For progressive recurrent MS, ocrelizumab (Ocrevus) is the only FDA-approved therapy. There are a number of other drugs for relapsing-remitting MS that may be prescribed by a neurologist to help reduce symptoms.
Treatment protocols for ALS and MS are best determined by your individual situation. Treatments are best determined in consultation with your primary care physician and a consultant such as a neurologist.