Do i need a spinal tap to confirm ms or can i be diagnosed via demyelination and lesions on my mri plus physical symptoms?

There are multiple options for diagnosis, spinal tap is not always needed. Visit this site for info: https://my.clevelandclinic.org/health/diseases/17248-multiple-sclerosis#:~:text=No%20one%20test%20can%20provide,cord%20that%20indicate%20multiple%20sclerosis.

My prior answers mention McDonald MRI criteria, which if fulfilled, can support diagnosis of MS; but if not conclusive, presence of spinal fluid oligoclonal bands can confirm. Make sure that alternative disorders are excluded.