1. Would an LP even be valid two-three years after an initial neurological episode? yes

2. Baclofen and reducing fever, seem to help with chest pain and therefore the doctors don't seem to want to test any further because of this - should I just leave it at that or have the chest pains evaluated further?
you have a band like chest pain which could occure mainly in a thoracic spine lesion..sometime a pancreatic disease could do the same..so the answer is yes

  Bob Hilton

Bob Hilton,
Thank you so much for your prompt and thoughtful, brilliant reply! Much appreciated. Your questions seemed to express my frustration but I haven't know what is missing from my care honestly. You seem very knowledgeable.

I am in 30s and have TM that can only be control with anti-seizure medication. It was bilateral and is now only on one side only thankfully. It gets worse in hot weather. 3 yrs ago, it was absolutely accompanied by facial spasms that actually got so bad my right eye was also affected.

I wasn't given an MRA - don't know what that is. Have never been given a thoracic MRI or a LP either. I was formally (on paper) diagnosed with Partial TM, and verbally told Probable MS. The ER saw me once for the chest pains and did one test - Electro cardio.???? for a bit and a chest x-ray, but never took it past that point to evaluate for anything. Rheum. problems have been ruled out, or so I've been told, so I haven't wanted to be a complainer about all this.

I had EPs done two years ago and they were normal. Cervical spine was done once but not with enhancement. I have flat out numbness at times now though, so something's up.

My urologist and new GP are getting concerned because bladder problems are worsening and causes of fever, other than to assume recurrent lung infections, have not been found.

Thanks you for replying - I will consider the tests you mentioned and expect more from my care.

1. Would an LP even be valid two-three years after an initial neurological episode?
2. Baclofen and reducing fever, seem to help with chest pain and therefore the doctors don't seem to want to test any further because of this - should I just leave it at that or have the chest pains evaluated further?

Dear Margt2
    Its hard to understand that you are below 50 with trigeminal neuralgia and did not have a full battery of MS investigation esp if you had ? transverse myelitis which will require a further lab work up esp a spinal tap?

    IF Hemifacial spasm entered the picture then the name will change from TN to "Tic convulsif "  which means even more imaging like MRA to rule out
1-ectatic dilation of the basilar artery,
2-or a vascular malformation compressing the trigeminal and facial nerves

the full battery of MS investigation
1-an MRI of the brain (which you have had)
2- and cervical spine with contrast (GD),
3- a lumbar puncture (for signs of inflammation,IgG index, oligoclonal bands)
4- Visual evoked potentials (done?),
5-somatosensory evoked potentials (done ?)
6- and blood work including lyme antibodies (done), ANA, ESR, CRP, B12 (done) and EBV/CMV antibody titers. .

this part of your post  of
2 yrs ago, recurrent pneumonia and dx Bronchiectasis
- found a 4mm pulmonary nodule
- followed and has been stable for 2 years
- told no more chest CTs needed
- Now, severe chest pain that goes around and through chest (feels like a crushing pressure) with infections/fever/colds
should not be solved on line , you should go to an ER for a possible Thoracic spine imaging and investigation for the cause of the fever

    I hope this is helpful
   Bob  Hilton