I was first told by a neurologist that I had TN after having a head MRI due to numbness on left side of my face two years ago. I didn't think that could be possible since I don't have any pain. I have seen a few more neurologists since then and the last one is at one of the top neurology/neurosurgery hospitals in the US, after repeat MRI with TN protocol they are saying I have TN due to neuro vascular compression and recommending surgery.
My question is- anyone else ever been diagnosed with TN and never have pain? I only have numbness that is constant, sometimes the side of my face feels hot, and I also have migraines that they think could be related.
Numbness and a feeling of heat in your cheek have more of the quality of trigeminal neuropathy than of neuralgia. And although vascular compressions are almost always found in cases of classic TN pain, they're seen in far more people who DON'T have pain. So I think I'd ask the most recent neurologist or neurosurgeon whether you are still considered a candidate for MVD surgery, given that you do not have the classic symptoms of a neuralgia and you do have symptoms of parasthesia sometimes seen as precursors to emergence of trigeminal neuropathic pain.
A separate question: have you ever injured your neck or face due to blunt force trauma, automobile whiplash injury, or dental work?
A lot of cases of facial pain are difficult to diagnose as anything other than "ideopathic" (basically, "spontaneous"). But I still think the question I posed originally is pertinent. Every surgery involves some risk of injury to the nerves. It's your decision as to whether the numbness and heat in your face are a sufficient reason to risk significantly increased pain if the surgery disturbs something that was basically stable before.