Is it possible to have MS without demyelination?

Hi, a member of my family was diagnosed with MS a decade ago. I know the disease is quite complicated, and that there are similar diseases to it. My relative had numerous relapses about 6-10 years ago. Since then they have been on medication and have not had a relapse in years, although they experience the odd symptom such as the MS hug. Reading over the diagnosis, it states there is “no evidence of demyelination”. After doing some research I have found that MS is a demyelinating disease. So is it possible to have no evidence of demyelination and still have MS? As I said my relative has had relapses, and has lost some vision, and was unable to move arms/legs properly. On the diagnosis it stated that possibility of family history involving MS. Which was basically one of my other relatives experiencing temporary loss of movement when they were young once or twice, with none of the other MS symptoms really. I should also add that there was no huge number of T cells in reports and tests done on my relative. So given all of that, is it possible that my relative doesn’t infact have MS? Clearly they have some sort of disease, but could it be something else?

Presumably the diagnosis was given after a MRI and lumber puncture? Demyelination can only be observed in MRI’s

Yes, but no demyelination was found

Yes those tests were done

MS is defined as a demyelinating condition. So no demyelination would seem to argue against the diagnosis. But really you’d have to ask the neurologist what made him/her diagnose MS in the absence of demyelinating lesions. Or rather, your relative should. Perhaps there were no lesions in the brain but there were on the spine?


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