First ask your doctore(they are all the same!) what kind of TN they think you have, is it T1(classic) or T2(atypical) of course you can have both(very rear but possible). I don't like the sound of TMJ business, are you involved with a dentist? some kind of dental procedure? Mine, a T2 type was caused by a full mouth implant restoration, the dentist(inexperienced) followed Academic book page by page, process of elimination and of course always denial that he did something wrong.. He did go thru TMJ and OVD and Myofadial and many other things except TN. I self diagnose TN and I was right, Inferior Nerve TN pain went away after implants were removed to my request. I have over 3 years experience of the worse pain that human can handle, I only found a relief using Gabapartine, currently taking 600mg daily.
Before I am able to help you tell me about the type of the pain you have, is it electric, jolting, is it local or spreads around one or both sides of your face? when did you first notice the pain? Don't forget that my dentist suggested brain surgery which I declined right away. Dentists allways try to blame someone else except themselves......
Currently I am in the process of removing all me implants(12) and start allover again. Sometimes we are our best doctors because we know where the pain comes froms, new dentists simply go by the book.....
Hold the phone. Vascular compressions are not the immediate (proximate) cause of TN; demyelination of the nerve structure is. There are many people in the general population who have compressions of veins or arteries against the TN, but who do not have the flares or burning sensations of trigeminal neuralgia. The proximate cause of the disease is the wearing away of the myelin sheathing coating the nerve bundle. Myelin may be stripped away because of a compression, a genetic predisposition, or an abrasion caused by a faulty facial surgery, a war injury, car wreck, or even as the result of spousal abuse. A normal functioning neuron has little spaces that are not myelinated; these areas are called "nodes of Ranvier," after the investigator who first described them. At these nodes, nerve impulses are speeded up. Why should elongated regions of demyelination result in nociception (transmission of pain messages)? No one knows for sure; it is the $600,000 question of TN.
It is very difficult to obtain certain diagnostic results from a standard MRI; it is, therefore, important to undergo a fiesta MRI. The general advice currently given by neurosurgeons is to undergo neurosurgery for TN earlier, rather than later. As one who works with young people who have learning disabilities, the "early intervention" model makes a great deal of sense to me. The longer TN goes untreated, the more complex that neuroanatomical changes will be. It makes great sense, then, to heed the advise of the neurosurgeons and get quality intervention early, rather than late in the disease progression.
If high-quality neurosurgeons are lacking in your area, please consult the website for the National Facial Pain Association. If you need out-of-network help to address your TN, you can find a general, sample letter at www.fpa-support.org "Knowledge Base." You can also contact (by e-mail) ■■■■■■■■■■■■■■■■■■■■. You will find suggestions for points you can make in your letter. You will also find suggestions for a letter from your referring neurologist.
I wish you the best possible of outcomes in your journey. Be well. Defeat the Beast!
Linda, I totally agree. It is so hard to live with the side effects of Tegretol or its more advanced version, Trileptal. The key to eradicating TN is to find a good surgeon. The overall success rate for MVD is 85-95%, and in some cases, neurosurgeons have a higher success rate. TN is the most painful condition known to humankind. Be kind to yourself. Find a good neurosurgeon who can give you a new lease on life.
Odeliasimone said:
Sharon, have you seen the neurosurgeon yet? I am so sorry you have been through years of misdiagnosis. The drug to have put you on, having TN, would be Tegretol. It does help. But I wanted to tell you that I suffered with TN pain for many years and to make a long, long sordid story short, I saw a neurosurgeon in 2006 who told me he thought my problem was the artery had fallen on my trigeminal nerve. He told me there was not a way to tell definitively; he would have to open me up first and go in and see. I said, "Do It!" He did and my artery had fallen down on the nerve in two places and in addition I had a blood vessel on it as well. He moved the artery up and off and put padding in between as well as oblated the blood vessel and I have been pain free ever since. The MVD surgery saved my sanity, if not my life! The wound behind my ear healed and my hair grew back. My surgeon was Dr. John Day. I had this surgery in Englewwood, Colorado but Dr. Day has since moved to San Antonio, TX.
I think the biggest point I want to make is to choose your surgeon carefully. It sounds like several people in this group have had no relief from an MVD surgery. I am not sure why this would be the case because if it is an artery impinging on the nerve it would make sense that it would be helped. Anyway, I don't want to speculate, but encourage you to undergo this surgery if this surgeon is confident and competent.
An abnormal blood vessel could be be cause of you TN. I was one of those cases where it was so. I was diagnosed with TN. My primary physician ordered an MRI and it was found I had a tumor at the base of my skull. It was thought that they were unrelated. My neurologist, a very highly respected one in Seattle and LA, also ordered an MRI and he noted I had a blood vessel that was dipping and touching a nerve. It caused me to have such raw pain in my head. I remember once being asked what level of pain I had and responded with "well a 10 would be a real branding iron, so I guess I'm a 9.9." But it did get worse. At that time my TN was still thought to be unrelated to my tumor. I had the gamma knife procedure and have been pain and medication free since then. It has been almost three years. In my case the TN pain was the key to finding the tumor which was in an inoperable location and if it had gotten much larger I would not have been able to have the gamma knife procedure. I am so very thankful that the tumor turned out to be the cause of the pain. Recalling the tremendous pain I had makes me well up with tears and my heart aches for any one experiences this.
Hi Dokie, I was lucky my wife is a Professor of nursing and extremely smart. I had an attack of pain that dropped my to the floor, god I couldn't believe it hurt so bad. She got an appointment with he Doctor that same day and and told him I had TN. They took the MRI and she looked at it and told them where the problem was and, yes it is TN.
I've had a PSR and it helped for about 2 years but with meds I could keep it under control but it came back.
I then went through the pain clinic thing and that was and is a bust. But you have to do it to get any Opaids OXY is my thing now. I'm not to fond of the thought of MVD so I shy away from it, I just had Raidosurgery and that is suppose to help for about 4 years < I don't know yet takes a month to find out.
Anyway that's my story and if you want you can private me and and I'll help all i can. Red is another choice to ask about things.
Best of all to you and hang in there things are always darkest before help comes along. You will hear a lot of sacrey things about operations that didn't work but it's you that you have to think about.
I was told by my neurosurgeon that I had a "home run" of an MRI but he still wasn't 100% sure that I had a compression on my nerve and couldn't be until he opened me up--and it turned out I had two compressions on the nerve. Everyone is built just a little bit different, you should meet with the surgeon and go with your gut. It's a big deal, the first surgeon I met with practically made me want to run screaming from the hospital, my second surgeon who I ultimately wound up going with made me feel so comfortable with my decision to go ahead with surgery that I knew it was the right thing to do. Sure, it's super stressful to hear that there's something funky going on with your brain but take a breath and don't feel pressured, no matter how many attacks you're having. You don't want to rush in to something and have a negative result.
So to answer your question, yes, I had two vessels that were causing my TN and it looks like I've got the same thing going on on the opposite side. It'll be okay!!
I was told by my neurosurgeon that I had a "home run" of an MRI but he still wasn't 100% sure that I had a compression on my nerve and couldn't be until he opened me up--and it turned out I had two compressions on the nerve. Everyone is built just a little bit different, you should meet with the surgeon and go with your gut. It's a big deal, the first surgeon I met with practically made me want to run screaming from the hospital, my second surgeon who I ultimately wound up going with made me feel so comfortable with my decision to go ahead with surgery that I knew it was the right thing to do. Sure, it's super stressful to hear that there's something funky going on with your brain but take a breath and don't feel pressured, no matter how many attacks you're having. You don't want to rush in to something and have a negative result.
So to answer your question, yes, I had two vessels that were causing my TN and it looks like I've got the same thing going on on the opposite side. It'll be okay!!
Hi Mojo, I have bilateral TN and at the moment both side are active. I'm on Tegretol and Lyrica 3 times per day but if I had the MVD 20 years ago I may be over it. From everything I've read about TN it's more effective if done shortly after onset of the pain and if done after 8 years from the first attack the result is not as good
Leonie said:
Mojo said:
Hi Sharon,
I was told by my neurosurgeon that I had a "home run" of an MRI but he still wasn't 100% sure that I had a compression on my nerve and couldn't be until he opened me up--and it turned out I had two compressions on the nerve. Everyone is built just a little bit different, you should meet with the surgeon and go with your gut. It's a big deal, the first surgeon I met with practically made me want to run screaming from the hospital, my second surgeon who I ultimately wound up going with made me feel so comfortable with my decision to go ahead with surgery that I knew it was the right thing to do. Sure, it's super stressful to hear that there's something funky going on with your brain but take a breath and don't feel pressured, no matter how many attacks you're having. You don't want to rush in to something and have a negative result.
So to answer your question, yes, I had two vessels that were causing my TN and it looks like I've got the same thing going on on the opposite side. It'll be okay!!
My MRI showed nothing. Often they won't, but a good neurosurgeon will know where to look based on where you are having pain. Turns out in my case due to abnormally thick skull plates I had bone compressing against the nerve. Neurosurgeon told me I have the thickest skull of all his patients, and mind you we are not talking just TN patients.
As for Gamma Knife, due to concerns of body radiation overload my neurosurgeon does not recommend it for TN, and after much research I agree with him.
I am pretty sure my input will not be of any use, but here goes ...
i am on a cocktail of drugs to manage my pain so it effects my memory ... i have to go back and look at my notes (a lot of times) to refresh my memory ... i think one of the first things my neurologist did was order an MRI ... i can't remember what he told me but i was placed on gabapentin , i think three times a day ... that worked for many years ... then i got the excruciating pain ... lightening strikes, someone sticking an ice pick in my face and twisting, the burning ... i called my neurologist for pain meds and in the beginning he would prescribe them for me ... then i was told they do not prescribe pain medication and i needed to go to pain management ... after asking relentlessly i was told i needed gamma knife surgery ... i had it, it didn't work ... then i found this group ... my life line
I find your comment makes a lot of sense, though I do understand when one is brain fogged due to meds, you wonder.
Bubblegum s I am pretty sure my input will not be of any use, but here goes ...
i am on a cocktail of drugs to manage my pain so it effects my memory ... i have to go back and look at my notes (a lot of times) to refresh my memory ... i think one of the first things my neurologist did was order an MRI ... i can't remember what he told me but i was placed on gabapentin , i think three times a day ... that worked for many years ... then i got the excruciating pain ... lightening strikes, someone sticking an ice pick in my face and twisting, the burning ... i called my neurologist for pain meds and in the beginning he would prescribe them for me ... then i was told they do not prescribe pain medication and i needed to go to pain management ... after asking relentlessly i was told i needed gamma knife surgery ... i had it, it didn't work ... then i found this group ... my life line
I am so glad you mentioned the myelin sheath and how that could be a factor. I truly believe that that issue is what is happening in my case, more than anything. Found out I had Vitamin B-12 deficiency when I went to a neurologist and once I started supplementing, my TN went into remission...for years. I just recently had a "waking up" of the nerve for a couple of stabs, but I think that could also be related to additional stress, so I'm working on that. So far today it seems to be settling back down quite well and for that I am very grateful. Thank you for your insight. I think it will help unlock another piece of the puzzle for many.
Cyndi
Janet McGee said:
Hi Sharon,
Hold the phone. Vascular compressions are not the immediate (proximate) cause of TN; demyelination of the nerve structure is. There are many people in the general population who have compressions of veins or arteries against the TN, but who do not have the flares or burning sensations of trigeminal neuralgia. The proximate cause of the disease is the wearing away of the myelin sheathing coating the nerve bundle. Myelin may be stripped away because of a compression, a genetic predisposition, or an abrasion caused by a faulty facial surgery, a war injury, car wreck, or even as the result of spousal abuse. A normal functioning neuron has little spaces that are not myelinated; these areas are called "nodes of Ranvier," after the investigator who first described them. At these nodes, nerve impulses are speeded up. Why should elongated regions of demyelination result in nociception (transmission of pain messages)? No one knows for sure; it is the $600,000 question of TN.
It is very difficult to obtain certain diagnostic results from a standard MRI; it is, therefore, important to undergo a fiesta MRI. The general advice currently given by neurosurgeons is to undergo neurosurgery for TN earlier, rather than later. As one who works with young people who have learning disabilities, the "early intervention" model makes a great deal of sense to me. The longer TN goes untreated, the more complex that neuroanatomical changes will be. It makes great sense, then, to heed the advise of the neurosurgeons and get quality intervention early, rather than late in the disease progression.
If high-quality neurosurgeons are lacking in your area, please consult the website for the National Facial Pain Association. If you need out-of-network help to address your TN, you can find a general, sample letter at www.fpa-support.org "Knowledge Base." You can also contact (by e-mail) info@tna-support.org. You will find suggestions for points you can make in your letter. You will also find suggestions for a letter from your referring neurologist.
I wish you the best possible of outcomes in your journey. Be well. Defeat the Beast!
The Facial Pain Research Foundation is conducting two main areas of research in the quest to find a cure for TN. One avenue is the genetic underpinnings of TN, and the other is an investigation into the development of nano pharmaceuticals that will target the Schwann cells. These are glial cells whose missions are to generate myeline to insulate neurons and nerve fibers as they are used in the learning process, and to repair myelin sheathing when it is damaged. Both avenues of research are unearthing breath-taking findings that will have direct applications, not only for TN, but for other forms of pain, as well. Some of the myelin-related research may also benefit patients who suffer from MS.
My daughter's TN was not caused by blood vessel compression. It was caused by damage to the trigeminal nerve during a botched corneal transplant. Patients who have MS have a slightly higher risk of developing TN, because MS targets myelin sheathing throughout the body and brain. Some of our veterans from Iraq and Afghanistan who have survived bullet wounds to the head have acquired TN. TN can also result from traumatic injuries related to car accidents and even spousal abuse.
Leoni, no two people who develop TN experience it in the same way. I've heard of patients having a flare-up and then going years without a repeat. The only generalization that you can make about TN is that it has no generalizations. Every case is individual; every case is unique.
Janet
Bubblegum, I am so sorry for the dismal outcome of your surgery. Please do not give up hope. There are neurosurgeons who are highly qualified who can give you the help you need. There is reason to believe that the work of the Facial Pain Research Foundation will yield treatments that could benefit you, too. There is always hope.
Cirrus52 said:
Hello Janet,
I am so glad you mentioned the myelin sheath and how that could be a factor. I truly believe that that issue is what is happening in my case, more than anything. Found out I had Vitamin B-12 deficiency when I went to a neurologist and once I started supplementing, my TN went into remission...for years. I just recently had a "waking up" of the nerve for a couple of stabs, but I think that could also be related to additional stress, so I'm working on that. So far today it seems to be settling back down quite well and for that I am very grateful. Thank you for your insight. I think it will help unlock another piece of the puzzle for many.
Cyndi
Janet McGee said:
Hi Sharon,
Hold the phone. Vascular compressions are not the immediate (proximate) cause of TN; demyelination of the nerve structure is. There are many people in the general population who have compressions of veins or arteries against the TN, but who do not have the flares or burning sensations of trigeminal neuralgia. The proximate cause of the disease is the wearing away of the myelin sheathing coating the nerve bundle. Myelin may be stripped away because of a compression, a genetic predisposition, or an abrasion caused by a faulty facial surgery, a war injury, car wreck, or even as the result of spousal abuse. A normal functioning neuron has little spaces that are not myelinated; these areas are called "nodes of Ranvier," after the investigator who first described them. At these nodes, nerve impulses are speeded up. Why should elongated regions of demyelination result in nociception (transmission of pain messages)? No one knows for sure; it is the $600,000 question of TN.
It is very difficult to obtain certain diagnostic results from a standard MRI; it is, therefore, important to undergo a fiesta MRI. The general advice currently given by neurosurgeons is to undergo neurosurgery for TN earlier, rather than later. As one who works with young people who have learning disabilities, the "early intervention" model makes a great deal of sense to me. The longer TN goes untreated, the more complex that neuroanatomical changes will be. It makes great sense, then, to heed the advise of the neurosurgeons and get quality intervention early, rather than late in the disease progression.
If high-quality neurosurgeons are lacking in your area, please consult the website for the National Facial Pain Association. If you need out-of-network help to address your TN, you can find a general, sample letter at www.fpa-support.org "Knowledge Base." You can also contact (by e-mail) info@tna-support.org. You will find suggestions for points you can make in your letter. You will also find suggestions for a letter from your referring neurologist.
I wish you the best possible of outcomes in your journey. Be well. Defeat the Beast!
The contrast material is Gadolinium and one should only do MRI's WITHOUT contrast. Never use Gadolinium even if it is recommended you need to make sure there is a valid reason and try anything valid else but this especially if you had multiple MRI's or even none and thinking about doing it. Read the FDA recent findings on Gadolinium found by Mayo clinic recently in the brain from people who have even good kidney function eGFR > 60 and it ends up everywhere in the body in some amount. Mayo clinic labs has a 24hr urine test and if you absolutely have to do it get the urine test done first to see what level of Gadolinium you have. There is also Geneva Diagnostics that has a similar test for heavy metals but Mayo is the best. There are to many variables to just do it. Early postings here suggest doing MRI's WOUT/W contrast as the "Gold Standard" but that was before Mayo Clinic and the FDA notification in July 2015 found the latest data on it. They are just to risky, find another way, given what Mayo and the FDA are reporting. I thought I had to do it but am sorry I did it as I had a toxic reaction eGFR > 60 and after the test was over some weeks latter and they don't go away. Even a single MRI with contrast should be avoided an alternative method should be tried.
It's hard having an invisible disease. People say, "But you don't look sick!" and you just want to have someone understand. Me, I would want a pity party, and there'd better be plenty of chocolate!
With TN, the question is not so much why does it go into remission, but rather, why does the nerve insist on sending only pain messages to the cerebellum? The truth is, there is no genuine assault to your physical well-being, so there should be no pain signals reaching your cerebellum. The $600,000 question with TN is why the TN bundle takes it upon itself to specialize in nociception (pain perception). When all is well with your nerves, they will send all sorts of messages to your brain: your relative location in space; what's the temperature; is that washcloth cold, hot, or just right? Is that a romantic kiss, or just a friendly peck on the cheek? Is that scarf nice and comfortably soft, or is it a scratchy woolen? With TN, the bundle of 150,000 nerves somehow convinces itself that it must tell you that there is an assault that threatens your physical well-being, and that assault is painful.
Pain is useful. It conveys information that your brain must obey in order for your body to avoid burns, bruises, contusions, bone breaks or other injuries. Pain tells your brain that there is something wrong with your physical state, and that you must slow down to take care of yourself. The pain of TN serves no meaningful purpose. Brushing your teeth eliminates food particles and plaque build-up; tooth brushing should not cause electrical jolts of pain. That high-pitched noise is music of the Baroque era, and it was intended to help you transcend into a prayerful mode of thought, not into a world of pain. Your mother just wanted to give you a kiss on the cheek so that you would know you were leaving her house with her love in your heart. Instead, you feel that there's a knife stabbing repeatedly into your eye. With TN, something goes terribly wrong with a specific part of your nervous system. To date, neuroscientists have not been able to figure out why the pain switch for the trigeminal nerve gets turned on and refuses to return to the "off" setting.
TN is vicious. I hope that the researchers are right in predicting that a cure will come out of the Facial Pain Research Foundation in 5 years. For many of you, I suspect that 5 years sounds like 6 years too many.
Cirrus52 said:
Hello Sharon,
I hope your visit with the neurosurgeon this Thursday goes smoothly for you! I had an MRI years ago where the radiologist said that it looked like there was a blood vessel pressing on the nerve so based on my history and the outcome of that MRI, I was diagnosed with TN. The biggest question I have though--if a blood vessel is really pressing on the nerve, how come I don't have daily pain and have gone into remission for long stretches of time?
So far I have found that supplementing with Methyl B-12 1000 mcg 2 tabs per day (chewable) has kept my TN at bay quite well. Recently though, it kind of "woke up" (just a couple of stabs so far) and I think it was due to additional stress, so I am working on getting that stress back down. Called the neurologist to ask what I can do for breakthrough pain and she has prescribed Lyrica. I'm waiting to see if it goes back into remission again before I start the med.
This site is loaded with suggestions, from medications to surgery and everything in between. The biggest help? Knowing that others understand what you're going through and can relate. I'm certain you will find the right path for you and don't ever give up searching.
Best wishes and just know that a lot of people will be rooting for you from the sidelines!
That is the one thing that amazes me--how my TN comes and goes like it does, often for very long stretches. I feel a sense of relief in that my lightning/stabbing attacks are generally rare. It's something I don't take for granted because I know that could always change later on--(knock on wood). I've decided to see if I can get in for a follow up visit with Dr. Kim Burchiel in Portland, who diagnosed me with TN years ago. I would love to know what he would suggest for people like me who only have it once every blue moon. It'd be nice to know if there's something that helps with the aching/burning that shows up before and after.
Leonie, I am so sorry that you are having to deal with this, where just eating and speaking can trigger it. That must be so incredibly difficult and I could see how it could really affect your quality of life. My hope and prayer is that soon someone will come up with a breakthrough that literally eradicates this type of pain once and for all. I know they're working on it, that's for sure.
Best wishes to you--and I'll be praying that your week ahead is as pain free as possible.
Cyndi
Leonie said:
CYNDI
TN especially in the early stages can disappear for normally up to 6 months
If it goes it should normally return, this is the advice from my senior Neurologist
With me the trigger points shift arounf the lips and corners of the mouth, eating and speaking can set it off
I waited about 5 1/2 years before I had my surgery and no, I shouldn't have waited that long. From what I understand the MVD is more effective if done sooner, I've been extremely fortunate that my right side is under control from the MVD. Has your neurologist told you that an MVD is completely out of the question for you? It sounds like your trigger points are exactly the same as mine, so I can absolutely relate to what you're going through. I hope you get some relief from the Tegretol and Lyrica, unfortunately I didn't have much luck with them. Right now I'm taking Trileptal and Topamax twice a day for the left sided symptoms, and while it knocks me out it does seem to be keeping my symptoms more under control than anything I had taken in the past. If need be I will under go another MVD for the left side, the surgery was a beast but it was nothing compared to the torture TN put me through.
Best of luck,
Mojo
Leonie said:
Hi Mojo, I have bilateral TN and at the moment both side are active. I'm on Tegretol and Lyrica 3 times per day but if I had the MVD 20 years ago I may be over it. From everything I've read about TN it's more effective if done shortly after onset of the pain and if done after 8 years from the first attack the result is not as good
Leonie said:
Mojo said:
Hi Sharon,
I was told by my neurosurgeon that I had a "home run" of an MRI but he still wasn't 100% sure that I had a compression on my nerve and couldn't be until he opened me up--and it turned out I had two compressions on the nerve. Everyone is built just a little bit different, you should meet with the surgeon and go with your gut. It's a big deal, the first surgeon I met with practically made me want to run screaming from the hospital, my second surgeon who I ultimately wound up going with made me feel so comfortable with my decision to go ahead with surgery that I knew it was the right thing to do. Sure, it's super stressful to hear that there's something funky going on with your brain but take a breath and don't feel pressured, no matter how many attacks you're having. You don't want to rush in to something and have a negative result.
So to answer your question, yes, I had two vessels that were causing my TN and it looks like I've got the same thing going on on the opposite side. It'll be okay!!
I waited about 5 1/2 years before I had my surgery and no, I shouldn't have waited that long. From what I understand the MVD is more effective if done sooner, I've been extremely fortunate that my right side is under control from the MVD. Has your neurologist told you that an MVD is completely out of the question for you? It sounds like your trigger points are exactly the same as mine, so I can absolutely relate to what you're going through. I hope you get some relief from the Tegretol and Lyrica, unfortunately I didn't have much luck with them. Right now I'm taking Trileptal and Topamax twice a day for the left sided symptoms, and while it knocks me out it does seem to be keeping my symptoms more under control than anything I had taken in the past. If need be I will under go another MVD for the left side, the surgery was a beast but it was nothing compared to the torture TN put me through.
Best of luck,
Mojo
Leonie said:
Hi Mojo, I have bilateral TN and at the moment both side are active. I'm on Tegretol and Lyrica 3 times per day but if I had the MVD 20 years ago I may be over it. From everything I've read about TN it's more effective if done shortly after onset of the pain and if done after 8 years from the first attack the result is not as good
Leonie said:
Mojo said:
Hi Sharon,
I was told by my neurosurgeon that I had a "home run" of an MRI but he still wasn't 100% sure that I had a compression on my nerve and couldn't be until he opened me up--and it turned out I had two compressions on the nerve. Everyone is built just a little bit different, you should meet with the surgeon and go with your gut. It's a big deal, the first surgeon I met with practically made me want to run screaming from the hospital, my second surgeon who I ultimately wound up going with made me feel so comfortable with my decision to go ahead with surgery that I knew it was the right thing to do. Sure, it's super stressful to hear that there's something funky going on with your brain but take a breath and don't feel pressured, no matter how many attacks you're having. You don't want to rush in to something and have a negative result.
So to answer your question, yes, I had two vessels that were causing my TN and it looks like I've got the same thing going on on the opposite side. It'll be okay!!
Mojo
I wipe Topricin or Zostrix HP cream on my lips where the trigger points are, most of the time it helps and it certainly helps me to have a meal or to speak. I'm forced to live like a recluse as most people don't understand. My best friend wants me to live on the coast but he doesn't believe I can't live in any windy areas, windy days are spooky for me as they can set off the big whammy
From everything I've read over the decades, it seems an MVD at onset is the best solution, the destructive procedures are risky but some people I've met prefer it to the pain
I should have had an MVD many years ago but surgeons didn't have enough data from patients so after 8 years of pain an MVD may not be as effective and the procedure may need to be revisited within 2 years