Diseases Similar to MS02.02.2023
Multiple Sclerosis (MS) is an autoimmune neurological disorder that affects the brain and spinal cord. It can cause a wide range of symptoms, including physical, mental, and sometimes psychiatric problems. While MS is the most common autoimmune disorder of the central nervous system, there are other autoimmune diseases similar to MS.
Neuromyelitis Optica Spectrum Disorder (NMOSD)
Neuromyelitis Optica Spectrum Disorder (NMOSD – also known as Devic’s disease) is an autoimmune disorder that affects the optic nerves and spinal cord. It is similar to MS in that it can cause physical disability, vision loss, and cognitive problems. However, NMOSD has a more specific set of symptoms, which include swelling of the optic nerve, inflammation of the spinal cord, and sometimes paralysis.
NMOSD is more common in women and can occur at any age but appears most often in females between the ages of 30–50 years, with a median age of disease onset at 40 years. It is a rare disease with a worldwide prevalence between 0.5 and 10 per 100,000 persons. (source: MS Nurse PRO blog)
NMOSD is a relapsing disease where relapses are followed by periods of some recovery. The most common relapses in NMOSD are optic neuritis, transverse myelitis, and area postrema syndrome, resulting in symptoms including eye pain, loss of vision, muscle weakness, paralysis, loss of bowel and bladder control, and severe nausea, vomiting, and hiccups (source: The Sumaira Foundation).
Relapses in NMOSD are often very severe and can result in incomplete recovery, leading to an accumulation of damage and permanent disability. Preventing attacks through early and ongoing treatment is therefore important to prevent long-term permanent disability. (source: MS Nurse PRO blog)
Myelin Oligodendrocyte Glycoprotein Antibody Disease (MOGAD)
Myelin Oligodendrocyte Glycoprotein Antibody Disease (MOGAD) is a rare autoimmune disorder that affects the brain and spinal cord. It is similar to MS, in that it can cause physical and cognitive problems, but MOGAD is distinct in that it attacks the myelin sheath of the brain and spinal cord, causing demyelination and damage to the central nervous system. It is associated with the presence of antibodies directed against myelin oligodendrocyte glycoprotein (MOG).
Furthermore, MOGAD is typically diagnosed in those between ages 10 and 30. MOGAD appears to be equally common among males and females. It presents in both adults and in children in different ways:
- In children, MOGAD more commonly causes attacks on the brain, resulting in symptoms including confusion, incoordination, double vision, nausea and vomiting.
- In adults, MOGAD often causes damage to the eyes (optic neuritis) and/or spinal cord (transverse myelitis) resulting in symptoms similar to NMOSD (e.g., loss of vision, weakness, paralysis).
(source: MS Nurse PRO blog)
Differences between MS, NMOSD and MOGAD
Multiple Sclerosis (MS), Neuromyelitis Optica Spectrum Disorder (NMOSD) and Myelin Oligodendrocyte Glycoprotein Antibody Disease (MOGAD) are all neurological diseases that affect the central nervous system.
The neurological manifestations of NMOSD and MOGAD may mimic those of MS, often leading to misdiagnosis. However, there are some key differences that differentiate them from one another.
DMTs used to treat MS can be ineffective against NMOSD, with evidence showing that some can even aggravate it further. It is therefore important to distinguish between these disorders owing to the differences in both therapeutic and diagnostic implications. (source: MS Nurse PRO blog)
Symptoms of MS, NMOSD and MOGAD
MS and NMOSD cause inflammation in the central nervous system and can have similar symptoms, such as muscle weakness, fatigue, and vision problems. MOGAD is a rarer condition that is similar to MS in some ways, but has more specific symptoms, such as ataxia, myelitis, and encephalopathy.
MS is usually diagnosed through a combination of medical history, physical examination, MRI scans, and laboratory tests. NMOSD is usually diagnosed through MRI scans, laboratory tests, and a spinal tap. MOGAD is more difficult to diagnose and requires a combination of MRI scans, laboratory tests, and spinal taps.
MS is usually treated with medications that reduce inflammation in the central nervous system. NMOSD is treated with immunomodulatory drugs that suppress the immune system. MOGAD is treated with immunosuppressive drugs such as corticosteroids or immunoglobulins.
MS has a wide range of prognoses depending on the individual. NMOSD is often associated with a poor prognosis, however, some individuals may have a more favourable outcome. MOGAD is a very rare disorder and there is not enough research to determine the long-term prognosis.
MS, NMOSD and MOGAD are all neurological diseases that can have similar symptoms, but they each require different treatments and have different prognoses. It is important to recognize the differences between the three conditions in order to receive the best possible diagnosis and treatment.
The following table highlights some of the differences to look out for between the disorders (source: MS Nurse PRO blog)
|Commonly affected age||20–40||30–50||0–40|
|Ethnicity||Any, mostly Caucasian||Any, African-American and Asian at higher risk||Any, unclear ethnic differences|
|Disease course||Relapsing (85%) or progressive from onset (15%); secondary progression can develop in relapsing form||Relapsing (>95%); progressive course extremely rare||Relapsing (50%) or monophasic (50%); progressive course is rare|
|Recovery from attacks||Generally good||Often incomplete, leading to permanent CNS damage||Generally good despite severe attacks|
|Key symptoms||Often fatigue or cognitive impairment||Severe vision impairment||Vision impairment, often with better recovery than in NMOSD|
|Area postrema syndrome||Rare||Sometimes seen||Rare|
|AQP4||AQP4 antibody seronegative||AQP4 antibody seropositive|
For more information about NMOSD and MOGAD, please visit the website of The Sumaira Foundation. The Sumaira Foundation is dedicated to raising global awareness of NMOSD and MOGAD, building communities of support for patients and their caregivers, funding research and patient advocacy.