Hi,
Whilst I understand your concerns,
Whilst meaning no disrespect to the pioneering DRs of MVD, one of which has recently passed away, who have helped many, MVD.....;
There is no evidence vascular compression causes TN, only that the PROCEDURE may help and has various elements,
Proposed vascular compression of the TN peripheral nerve follow few rules of any other peripheral nerve compression,
Folks are shown to have vascular compression and no TN symptoms,
Why isn't vascular compression of extra-cranial nerves not seen as a problem,
The right side is more affected, when the left has a larger nerve root,
MVD doesn't help a lot of folks,
The trigeminal nerve root has its own internal blood supply including an arteriole, yet an artery outside of it is said to be the accepted cause???
Remission is put down to remylination of the nerve fibres, yet circa 30% of the nerve fibres in the root are unmylinated,
Medical intervention at the neck- nerve blocks have helped folk, which doesn't address vascular compression,
Dental intervention/ procedures are stated by patients circa 30% accordind to RED's survey on this site, as the route cause of certain cases, they don't cause vascular compression at the nerve route,
A lot of folk circa 30%+ state postural issues affect their TN, but less reported are things that would have a more direct affect on blood pressure, and hence vascular compressions at the TN nerve root,
Many people have additional syndromes e.g. Migraine for which MVD is not a procedure, but share a common mediator at the spinal trigeminal caudalis situated in the neck, recent research shows a connection between the two.
A number of folk are diagnosed with TN, with additional symptoms which overlap with other head/ facial pain complaints; occipital neuralgia, migraine, tearing, swelling, inner ear pain etc. the common denominator- not vascular compression at the TN root
Individuals do exhibit other cranial neuralgias which show a common neuronal connection in the nucleus mentioned above. Have they also got vascular compression on these nerves that occur no where outside of the cranium? yet they have a connection, these cranial nerves, in the spinal trigeminal nucleus,
Some people, and research, as with the above, has shown a connection, have one of many autoimmune diseases, many of which have musculo-skeletal implications acting on the spine and joints, where the spinal trigeminal nucleus sits.
"PERSONNEL opinion, vascular compression (AVM's, chiari etc., excluded ) as told doesn't cause cranial nerve neuralgias.
As time goes on, even the weekly research as stated on pubmed, the likely hood of vascular compression causing TN would seem less and less likely, or at least it adds a great big question mark."
In summation, all avenues should be investigated before destructive procedures.
Present day, if not sorted G.P. >>Meds>>Neuro>>>Meds>>>neurosurgeon>>>needle/ knife/ nasty drill, far from the ideal situation.
Some would argue for evidence based medicine, how much evidence- none before the first MVD's were carried out, My belief is that the spinal trigeminal nucleus was not even identified before Dandy proposed the theory of vascular compression at the TN nerve root.
I'm sorry you and your husband are going through this understated ordeal, but a possible trigger of a biceps surgery would not seem to correlate with vascular compression, although I obviously don't know the cause of his biceps problem a poor nerve supply to the tendon from the neck can cause injury.
Wishing you and yours well.