Hi and welcome,
I'm really not sure how to answer your question about your neurologists feeling....
There honestly isn't enough diagnostic information provided for anyone to consider 'yes' as an answer to your question "Could he feel I definitely have MS even though neg MRI?"
Based on the minute diagnostic information you've provided, as in normal MRI 20 yr's after your first MS work up, the logical answer would have to be 'no' because it wouldn't make diagnostic sense for a neurologist to even put a neurological condition like MS on your potential causes list if there isn't any MS consistent or suggestive diagnostic evidence.....It's just way too big a leap to assume your neurologist could have any thoughts that you "definitely" have MS despite a normal MRI.
There would need to be a rational in your neuro referring you to a big hospital eg availability of specific tests, more experienced or specialist neurologists ie neuro-psychologist, neuro-ophthalmologists etc etc despite your normal MRI. Do you know if you have any abnormal neurological clinical signs eg clonus, neurogenic bladder and or bowel, Optic Neuritis (ON), Charcot triad (dysarthria, nystagmus, and intention tremor) etc etc etc?
Hope that helps......JJ
I had a spinal tap a number of years ago to be certain of my diagnosis of MS. The test came back negative, so the Dr said that I don’t have MS. I’ve since seen a different Dr. who gave me a diagnosis of MS. While he showed me the MRI he noted all the white lesions on my brain. I outright asked him if my lesions were considered “a lot”. He then answered “yes”. After the previous Dr experience, I asked because I wanted to ne certain that I had MS. In other words, I don’t believe that anybody with MS is positive for every symptom there is.