Is It MS or Parkinson’s?

Multiple sclerosis (MS) and Parkinson’s disease often seem a lot alike. Both diseases can cause your hands to shake, for example. Does that mean the two conditions are linked?

While some signs of MS and Parkinson’s look the same, they’re different diseases. You can have both at the same time, though.

How Are They Alike?

MS and Parkinson’s both affect your central nervous system, which includes your brain and spinal cord. That’s why they both can affect how you move, sleep, feel, and talk.

These diseases both affect your nerves. MS can break down the coating, called myelin, that surrounds and protects your nerves. In Parkinson’s, nerve cells in a part of your brain slowly die off.

Both can start out with mild symptoms, but they get worse over time.

Common symptoms of both diseases include:

  • Shaky fingers, hands, lips, or limbs
  • Slurred speech that’s hard for others to understand
  • Numb or weak limbs that make your walk unsteady
  • Loss of muscle control that often affects one side of your body at first, then later both
  • Spastic limb movements that are hard to control
  • Loss of bladder or bowel control
  • Poor balance

Depression is another symptom common to both conditions.

What Makes Them Different?

MS and Parkinson’s have different causes. They usually start to affect you at different ages, too.

MS often affects people between ages 20 and 50, but children get it, too. Parkinson’s usually starts at age 60 or older, but some younger adults get it.

MS is an autoimmune disease. That means your body’s immune system goes haywire for some reason. It attacks and destroys myelin. As myelin breaks down, your nerves and nerve fibers get frayed.

In Parkinson’s, certain brain cells start to die off. Your brain makes less and less of a chemical called dopamine that helps control your movement. As your levels dip, you lose more of this control.

Some genes may put you at risk for Parkinson’s, especially as you age. There’s a small chance that people who are exposed to toxic chemicals like pesticides or weed killers can get it, too.

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These symptoms are more common if you have MS. They not usually found in Parkinson’s:

Parkinson’s can have some symptoms that people with MS typically don’t have:

  • Slowed movement (your doctor will call it bradykinesia)
  • Feet drag or shuffle
  • Stiff, rigid muscles
  • Poor posture
  • Loss of control over how you blink, smile, swallow, or swing your arms when you walk
  • Small, cramped handwriting

Is There a Link

Some people have MS and Parkinson’s, but it could be a coincidence.

Research suggests that the damage that MS causes to your brain can lead some people to develop Parkinson’s later on.

If you have MS, your immune system triggers ongoing inflammation. This can create lesions in your brain that cause Parkinson’s disease. If lesions form in certain spots in your brain, they can affect how it makes dopamine.

How Do Treatments Differ?

MS treatments can ease your symptoms during an attack or slow down the disease’s effects on your body.

Steroids like prednisone calm the inflammation that damages your nerves.

Plasma exchange is another therapy if steroids don’t work. Your doctor will use a machine to remove the plasma portion of your blood. The plasma gets mixed with a protein solution and put back into your body.

Some people with both diseases who take anti-inflammatory medicines like steroids see their Parkinson’s symptoms get better.

Disease-modifying treatments slow down MS nerve damage and disability:

Ocrelizumab (Ocrevus) is the only FDA-approved medicine for primary progressive MS, the rarest type of MS. It’s also an option to treat another type called relapsing-remitting MS.

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Other disease-modifying medicines for relapse-remitting MS include beta interferons as well as:

Medications to treat Parkinson’s either raise your dopamine levels or offer a substitute. They can ease Parkinson’s symptoms like tremors. Over time, they may become less effective.

Medicines used to treat Parkinson’s include:

  • Amantadine, which relieves symptoms in the short term. You may also take it with carbidopa-levodopa.
  • Anticholinergic drugs to help control tremors
  • Carbidopa-levodopa, or an infusion of both drugs called Duopa, to help boost dopamine levels
  • COMT inhibitors like entacapone (Comtan) or tolcapone (Tasmar), to help drugs that boost dopamine levels work better
  • Dopamine agonists: pramipexole (Mirapex, Mirapex ER), ropinirole (Requip, Requip XL), and rotigotine (Neupro) to mimic the way dopamine works in your brain. Your doctor might also give you a short-acting version for quick symptom relief called apomorphine (Apokyn).
  • MAO-B inhibitors: Selegiline (Eldepryl, Zelapar) and rasagiline (Azilect) to control dopamine levels

Deep-brain stimulation is another treatment for Parkinson’s. A doctor places electrodes into your brain. They send out electric pulses that ease symptoms in your body.

WebMD Medical Reference Reviewed by Melinda Ratini, DO, MS on September 25, 2017

Sources

SOURCES:

National Institute for Neurological Disorders and Stroke: “Tremor Fact Sheet.”

Neurology: “Parkinson’s Disease in Multiple Sclerosis - A Population-Based, Nationwide Study in Denmark (P2.186).”

Mayo Clinic: “Multiple Sclerosis: Overview,” “Multiple Sclerosis: Symptoms and Causes,” “Multiple Sclerosis: Treatment,” “Parkinson’s Disease: Causes,” “Parkinson’s Disease: Definition,” “Parkinson’s Disease: Risk Factors,” “Parkinson’s Disease: Symptoms.”

Christopher Reeve Foundation: “How the spinal cord works.”

National Association for Continence: “Parkinson’s Disease.”

National Multiple Sclerosis Society: “MS Symptoms,” “Who Gets MS? (Epidemiology).”

National Parkinson Foundation: “Non-Motor Symptoms.”

Multiple Sclerosis Trust: “Lhermitte’s sign.”

Iranian Journal of Neurology: “Parkinsonism associated with multiple sclerosis: A report of eight new cases and a review on the literature.”

Johns Hopkins Medicine: “Plasmapheresis.”

Clinical Neurology and Neurosurgery: “Parkinsonism and multiple sclerosis – is there association?”

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