Hi, and welcome to the forum. Your post brings up three or four points that need to be discussed and possibly explored by your doctors.
The first is that you have "MS-like" symptoms and multiple lesions in your brain on MRI. Kudos to your neuro that he is not going to take the idiot's way out and say the lesions are due to age. However, for some reason he has said that the lesions are not "active". This is a recurring point that I need to do a whole post on. I suspect that your doc means that none of the lesions enhance. Enhancement is seen with new lesions that indicate that the blood-brain barrier has been broken and immune cells have leaked across to cause inflammation. So, lesions that don't enhance with the contrast are active with inflammation.
Those lesions you have may well be "active" in that they may be causing you symptoms. No one can say that lesions seen on the MRI aren't neurologically active if the patient is having neurological symptoms. It is impossible to draw direct correlations between lesions and symptoms. Too many doctors do not know this.
This article maight help:
Since you are not yet diagnosed it is interesting that you have had what sounds like a confirmed stroke. If so it is important that you have been tested for two of the common MS-mimics that cause strokes. The first is Anti-Phospholipid Syndrome (also known as Hughes Syndrome). In this condition the person has antibodies which cause an increase in clotting. The person may have multiple small stokes, a history of repeated miscarriages, history of deep vein thrombosis, or a family history of those things. It is important that you and anyone being worked up for MS to have this testing. It is a panel of blood tests.
Another MS mimic causing strokes is a condition called PFO - Patent Foremen Ovale. This is a small hole which has persisted between the two sides of the heart. Tiny little clots which form in the veinous circulation can slip through the hole and then be shot directly up to the brain. This condition is usually tested for by a cardiologist.
We have seen both of these conditions be the cause of someone having MS-like symptoms and multiple brain lesions. Just in case your doc hasn't considered these possibilities.
The O-Bands (standing for Oligoclonal Bands) form during the course of the disease. You don't need to wait for a relapse to catch them. Once you have an O-Band in the CSF it will likely be there life-long. You gradually acquire more and more of them. The second LP test that can suggest MS is the IgG Index which is a derived number indicating how much more or less immune activity is happening in the CNS as opposed to the rest of the body. It is possible that this number might be changed somewhat by a concurrent relapse, but, I have never read that it is desirable to wait for an attack to do an LP. Some neuros believe that, but I do not believe that the delay in diagnosis is worth the possible small change in the test results.
An LP will not be changed by having an active lesion.
I have been out of the MS loop for much of the last year and am new to the gMS Glycominds test. It looks promising, but I haven't seen scientific validation of it yet. Other promising biomarker tests for MS like the MOG and MBP proteins were shown to have no use when they were studied rigorously.
I am interested in what symptoms you have been having and what your thoughts are on my comments. If I have missed them, I apologize. I am only newly back to participating here after a really bad year.