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If you continue to be ill with symptoms consistent with lupus, then periodically you should have the blood tests for it rerun. Many people report getting sick first, for up to a few years, before positive blood work was found. This wasn't the case for me, but there are several reports here of that happening.

Furthermore, there is something called ANA negative lupus. Only the most experienced lupus specialists seem to be confident enough to diagnose that though, unless some more concrete evidence such as a skin biopsy or a kidney biopsy shows lupus.

I'm not well versed in CNS lupus, but my understanding is that often there is some sign of it visible on MRI - especially if it is done with contrast (then more of an MRA actually). However, things aren't always found on MRI/MRA and people have often had a few normal MRI's before something was found abnormal. Hopefully some will come along in the next day or two with their personal experiences and/or some good links on the topic.
 
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