The SFN in the face seems logical IF you have SFN elsewhere. Did your skin biopsy show SFN in your feet (I'm sorry, I have memory problems and can't recall previous posted info)? The NCS cannot detect SFN (I'm sure you've read all the posts on this from Glenn and others...but skin biopsy is the only way to look at small unmyelinated fibers), so he must be drawing this conclusion from the location to TM nerve and giving it his best thought as to the cause. What does your neurologist have to say? I would be nice if the oral surgeon spoke with the neuro

Honestly, I really think the SVID is playing a role too. Of course this becomes more common as we age but it is still NOT a normal condition...no matter what age. It is also a sign of possible small vessel disease elsewhere, like coronary vessels. And with your family history, I would think flags should be going up and this given more consideration (not just for the cause of your face issues, but also whether CVD may be a factor). You really should be given a full cardiac work-up with your history and other symptoms you mentioned.

Your face may be a combination of problems...like TN involvement and your small vessels. But with either (or both), it will likely come down to getting used to it...which you will over time. I thought I would never get used to mine but over the years I have done so. Our bodies have a way of learning to compensate and get accustomed to new feels and such. It's when things are new that it is the hardest to cope.

It will be interesting to see what improves after your surgery...hopefully, quite a bit!! You sure have your plate full right now.