I would definitely get a second opinion. I treated with medications, acupuncture, laser treatments, and chiropractic care for 4 years. I was initially told MRI was normal. Finally went to John Hopkins and Dr Lim looked at my MRI from 4years ago and saw a problem. Had surgery 4 months ago and am doing great. Dr also told me that an MRI doesn't always show the problem. I actually had an artery and a vein pressing on my nerve at two different areas. Dr also said that if he does surgery and finds nothing he can inject the nerve directly which has longer lasting pain relief. Wish you well.

Thank you so much. : )

agree need second opinion. all my mris and mras came back normal but at least we eliminated certain things by these tests.
also i am trying a new treatment called ultra sound nerve block at northwestern memorial hsopital in chicago.
so its not always just medication. in my experience i waited too long to try other things to feel better quicker.
blessings for pain free days!

of course you need an MRI - to learn the cause of your TN - if it's primary: due to a blood vessel or secondary: for example to MS. Mine turned out to be caused by MS and it's best to start treatment as early as possible. Not saying that that's the case with you, but best to rule things out &/or get a move on treatment as necessary. Good luck!

I had MRI's and CT scans neither of which pinpointed the cause of my TN. I have been off meds for about 4 years and have had no recurrence of attacks. However, just recently I have had a few shocks in the tongue which is how my attacks first started. So far they have been isolated and have not progressed to full blown attacks. However I am watchful and at the first sign of progression I will go back on Carbamazepine which always controlled my pain. I was lucky in that I needed only 400 mg a day.