In early multiple sclerosis could be neurological examination negative but mri positive?could neurological examination and mri both negative?thanks

Yes: Unfortunately, MRI imaging and other tests are not always specific enough or diagnostic to determine if a patient has MS or not. Some patients without MS have a positive MRI study. Negative examination and MRI are fairly reliable in excluding MS. However, MS is a disease that worsens and improves, and your exam may be relatively normal at times. Multiple exams over time are needed to exclude MS.

Comments: If both MRI and neurological exam fully normal, you do NOT have MS. If MRI shows white matter lesions, MS could be but one of many explanations. Radiologically isolated syndrome could be one of the earliest signs of potential MS, but a normal exam would suggest that the abnormalities might be more likely associated with migraine, head injury, smoking, etc.