2 years ago i was diagnosis with transverse myelitis. again i had another lesion on my spine close to the first one past and present brain mri was clear should i be doing a spinal tap. could it still be ms?

MS myelitis: Two lesions in the spine are very strongly suggestive of ms absence of brain lesion does not rule out ms check with a good neurologist so u can be treated with disease modifying drugs to prevent future worsening.

TM & MS: Spinal tap does not confirm ms. It shows high igg, protein and leukocyte, also found in other immune diseases. Interestingly your mrix2 showed no brain lesion but what about spinal cord & optic nerve. Dx of ms is on neuro deficits & mri. Some thinktm is first episode of ms. Tm %conversion to ms is variable. The deficits are shown as where the myelin lesions are -on the cord, optic nerve or brain.

This needs diagnosis: Need to tie this down. First, get aquaporin-4 study for neuromyelitis optica, and also visual evoked potential which is twice as accurate as mri. Yes, it could very well be ms, and you should get spinal fluid and check oligoclonal bands, but send fluid to mayo clinic, not locally. Lastly, get a second opinion asap. Ms drugs will make worse if nmo. Other problems should be excluded.