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Hey Alaine   I am just going to add onto what Lisa has already said by telling you about my personal experience.  My neurologist wanted to do a spinal tap as well.  I had my MRI which showed multiple lesions, I had the evoked potentials test for vision and hearing (this did not reveal anything), and my symptoms.  I basically refused to do the spinal tap and they ended up not needing it.  I did have to get more MRI's which did show a slight change and this is what they needed to make the official diagnosis.  So I think it just depends on the doctor.    I think that some docs are just more conservative in their making the diagnosis.  The drugs are costly and do have side effects so they want to make sure that you do have MS.  And the insurance companies do not want to pay for things unless they have that official for sure diagnosis.  I have been reading, however, that some folks get MS drugs for one clinically isolated syndrome such as optic neuritis in order to prevent MS from developing.    At any rate, it was my personal experience that I did not need a spinal tap to make my diagnosis and I waited six months from the first MRI to the second to receive my diagnosis.  It is totally up to you as to how you wish to proceed.   Thanks for your question.  I hope you get the answers you are looking for.