There are other diseases out there that mimic MS however with the lesions (plaques) found on the MRI along with his symptoms are highly suggestive of MS. His doctor would want to rule out other diseases before zeroing in on MS.
Spinal? Are you talking spinal tap? If so, it is not needed for a dx nor to rule out. I've had two and the last one I wanted to curl up in a corner and disappear.
As far as to what to expect...it's unpredictable and your brother will need to be monitored by his neurologist and overtime it will be determined what form of MS he has...it could be RRMS and then 10 years from now it goes to SPMS...it just depends on how MonSter treats him. There is no cure for MS however if he gets on a treatment which slows down the progression is the key to staying as healthy and active that he can be under the circumstances.
(below came from a previous post that I had posted to another MS question)
MS is a tricky creature. It comes in different forms...best way for me to tell someone when they ask what it is? (some think it is the same as Muscular Dystrophy...so I educate them)...it is an unpredictable disease of the central nervous system...key word being 'unpredictable'.
nmss.org or mssociety.org are both great websites to learn about MS. It is so managable...I fall between benign and RRMS (descriptions listed below)...I listen to my body over the last 8 years than I ever did...if I get a little too hot, I know to find a cool spot as sometimes heat steals the use of my legs...however if that happens, I cool down and I'm good to go...like going for a long walk...years ago, I ended using a cane because my legs did not want to function correctly, lasted a few weeks, hasn't been back. If people ask what happened...'it's an old injury and just needs to heal once more'
To be honest, I hope you do not have MS and that it is stress and / or B12 related or something simple...but if you must join our club, you'll have great support & resources at your fingertips.
There are four types of MS, each with its own characteristics, but each as unpredictable as the other. It might not be clear which type of MS you have when you are first diagnosed. However, by noting changes over time, your neurologist should be able to clarify the type you have.
Relapsing Remitting MS
Most people are diagnosed with relapsing remitting MS. This is when you have relapses (a flare-up of symptoms), followed by remissions (periods of recovery). Relapses are unpredictable. They can last for days, weeks or months and vary from mild to severe. During a relapse you will either experience new symptoms, or a reccurrence or worsening of previous symptoms. During remission, symptoms can disappear completely, though sometimes people make only a partial recovery.
Symptoms might not always be due to a new relapse. For example, exercise or hot weather can sometimes raise body temperature and make symptoms temporarily worse. Any changed or new symptoms must last for at least 24 hours to be described as a relapse.
Secondary Progressive MS
Most people who have relapsing remitting MS later develop a form known as secondary progressive MS. This type of MS is identified when your condition becomes steadily worse, and your disability progresses, for a period of six months or more, whether you continue to have relapses or not.
Benign MS
If you have a small number of relapses followed by a complete recovery, you may be described as having benign MS. It is only possible to make a diagnosis of benign MS once you have experienced little or no disability for a period of 10 to 15 years. However, a diagnosis of benign MS does not guarantee that you will be free of problems; a relapse may occasionally occur after many years in which your MS has been inactive.
Primary Progressive MS
With primary progressive MS, symptoms steadily worsen, resulting in a continued progression in disability. You will not have distinct relapses and remissions.
~Zig