Hi, I am more than happy to answer your question. The number one procedure that I was told over and over again is mvd. The great book about tn called Striking Back says that also. All known documentation is that mvd is the first line procedure of the condition. I was scared and did not want it. So I made the decision to have the gamma knife. Well, 8 to 9 months later, I started getting this horrible non stop pain in all the 3 branch areas and my tongue. It feels like a million bees are on my face and keep biting me all the time. It will not stop. My tongue is like on fire. The doc says that the gamma knife damaged the nerve and this will not go away. So........I had the mvd this week and the tn attacks are gone. I will I had this done in the first place. My attacks are gone...........but not this horrible numb/pain face 24/7. Please get the book Striking Back and read it and then you can make your decision. I also found that the neurosurgeon get paid 4 times more money to do the gamma knife than the mvd...........go figure.