I'm also diagnosed with both MS and Trigeminal Neuralgia. I take Klonopin + Cesamet and had to discontinue many types of birth control methods that threw my hormones out of whack and triggered TN attacks (both typical and atypical type attacks - I'm affected on both sides).

My doctors are aware of these attacks, but they've not suggested surgery. The medications for the most part keep things in check, but I do have occasional breakthrough moments of pain.

You mention that MVD (correct me if I'm wrong with the acronym) isn't available for those with MS. Why is this, or was this one doctor's opinion?

I'm curious myself as this is a symptom that is quite dominant in my own case of MS, unfortunately I don't have much info to offer on the surgery side, only the medications and choices (birth control cessation primarily) which have helped me.

I hope you can find some answers to your questions and concerns.