Hi rparrack, so sorry to hear about the struggle you are having. I don't know much about atypical TN. Keep trying to get answers and find things that help! Perhaps the pain will ease in time. It's interesting that the worse pain is about once a month. Can you identify anything you do or eat that is different at those times. You say stress is a factor, so I hope you are working on ways to lower your stress (meditation, yoga, etc.) I wish you the best.