Diplopia for 4 years, mg antibodies negative, mri shows "ms lesions" and just had lp. any ideas on other possible causes, or type of ms? thanks!

Pin down answer: Sounds like will be ms, and spinal fluid may well be confirmatory. If lingering questions, a neck MRI lesion or gray matter lesions will add support to diagnosis. Although the most frequent presentation is relapsing/remitting (85%), some pts do start with primary progressive. Make certain that other causes have been considered, such as lyme, b-12, lupus, etc. If ms, consider oral agent.