So confused by MRI results and deciding on surgery, please help!

Hi, I'm new here, but have been reading everything! My TN pain started about a year ago after a major botched dental procedure which led to an extraction, which led to emergency sinus surgery, so I've been pretty sure my TN has been from dentistry problems. My MRI just came back, it was the very detailed one, and it was perfectly clean. Now I'm confused... will surgery help me if no areas are shown to be touching the trigeminal nerve and I'm pretty sure it was caused by damage during dental surgery? Where do I go from here? So far, the only thing bringing me any relief is sleeping with a lidoderm patch on at night. any information or ideas would be welcomed! Thanks so much!

Like many others, my MRI did not show anything but I did have the surgery last December. My surgeon found an artery and a vein that were compressing the nerve and I have been pain free since the surgery.

Good luck to you!

So many of us here have a clean MRI but we DO have TN. A lot of members are found to have compression during surgery. It can apparently be difficult to see compression on MRI.

Thanks so much for letting me know that, it’s good to know that can happen, phew!

My MRI/MRA was also clear and I had 2 done (diagnosed this past January). I saw Dr. Casey though and he did see the compression clearly after 2 other neurosurgeons and 2 neurologists saw nothing. Sometimes it just take a very trained eye in finding that compression. It sure did give me some peace of mind though scheduling for my MVD in October. Maybe you should have your MRI reviewed by several surgeons and especially by one who has extensive experience with TN and MVD surgeries. Best wishes!

I had many MRIs done and no compressions were seen. That being said, I don't know if the doctor's ever requested a thin sliced, high resolution MRI which is supposed to be better in detecting nerve compressions. Based on my history, my neurosurgeon thought I should go for MVD anyway and I had it done 9 months ago. I had 3 nerves compressed by 2 arteries.

Now, I did not have any dental and/or sinus trauma or surgery. I do not know if your history of having a botched dental procedure and sinus surgery would mean there's more of a chance that that was the cause of your TN and not a compression. I'm sure others here that have had the same experience with dental and sinus procedures will have more information for you.

Thanks everyone for all the help... I am confused, but if I understand correctly if it were a damaged TN nerve from dentistry then I would be having pain all the time with excacerbations, is this correct? If it is true TN then it is more likely quiet in between the "thunderbolts" of pain that I am getting? Because it's definitely quiet and just sneaks up on me, most of the time triggered by hot or cold foods, sometimes by brushing my teeth. Does this make any more sense? This is sure a confusing thing to diagnose and treat, that's for sure!