For some people it is not uncommon to have numbness and tingling post attack. If you think about it all the nerves in your face are effected, as are the muscles. Everything tenses up and like most of us you are probably clenching your teeth..so it would make sense that you have some kind of after effect.

That's when most of us use some sort of pain med usually an opiate because they work fast and are effective,,unless you have a medical reason to avoid using them don't be afraid to, now is the time to start viewing medications differently. We don't take this stuff to get happy we take it to control pain and that should become your new focus..how to control pain.

If your diagnosis is ATN, then you have to deal with controlling a constant pain as well as our well known "lighting bolts". So if you have issues with taking meds you need to start changing that. Like it or not that is our first line of defense, and for many TN and ATN patients there is no need to go any farther if you can find the correct med or combination of meds that give you enough pain control to have a reasonable quality of life.

As TN patients we no longer look to be pain free we look to be pain controlled. It's not perfect but you can still find a good quality of life..Too many patients give up and give up their lives and most often it is not necessary,,it takes time and the right combination of MD's that become your partners in helping you control this. I have ATN so I speak from experience.

You said you have seen a Neuro,,if you are still having that kind of breakthrough pain you need to evaluate your meds. We all have breakthrough but it should not be that severe,,have you both considered adding another med to work with the Tegretol?? or possibly upping the dose. The real question is does this MD really listen to YOUR concerns or does he talk at you? It's not uncommon,, they do have a tendency to think they are Gods....terrible but true. You need to evaluate if this is the right MD for you.

If you are very comfortable with his performance....I still suggest a second opinion. Perhaps another MD may fit your needs better. I know I mentioned it before but why a Balloon compression,,is there another medical issue that prevents a Gamma Knife? Still not my favorite procedure but has better results than balloon compression. Get online and do your homework on these procedures,,find out the pros and cons, don't rely on your MD to tell you everything...sad but true.

This is the really hard part,,there is no procedure that will guarantee pain relief. I had an MVD and it actually made it worse..it's not uncommon, and please know that I went to a world class Neuro at a top 10 hospital. Not everyone is a good candidate. I am assuming that they did a contrasting MRI so it showed your vascular system as well, so if they can't see somewhere that would indicate (not guarantee) some kind of interaction then perhaps your ATN is not caused by the "normal" reasons.

I have figured out that my ATN is viral based. I saw another Neuro a few years ago hoping that perhaps imaging had gotten better over the years and perhaps I had a better chance at doing an MVD again. He informed me that there is a group of people who develop TN very quickly and they really can find no reason why we get it. I asked him point blank could it be viral based and he said, no one will admit it but between MD's that is their belief as well.

At least he was honest with me...have you been diagnosed with fibromyalgia or chronic fatigiue syndrome?? If so you may have an answer. Or at least another place to start. Let me know on that one I may have other resources for you.

What may end up happening is that instead of continuing with a Neuro you may need to make the move to a pain mgmt MD. But be advised that it needs to be with a major hospital with certified pain MD's (usually anesthesiologists ) because they have the ability to RX meds that your Neuro can't. Their bag of meds and procedures is different, the problem may be that usually to get in as a patient you have had to give a bunch of meds or procedures a try before they will see you....however every place is different so start looking into what you have near you and what your options are for they future.

I've been through it all,,the meds and two major procedures and I made the jump to pain mgmt very early on,,I was lucky to find an MD that was willing to learn more about TN and how to treat me...he's saved my life more than once. But it took time and building a relationship with him I am very grateful to him for all his help over the years. I now have a PNS (see the thread here for PNS) which has made an enormous difference but in the US it is still not FDA approved and is NOT for everyone with ATN. Remember I have been dealing with this for a decade you are just at the beginning of this road, I mention it only because,,there is hope.

This PNS procedure will be approved within the next few years but don't count on it anytime soon for someone who is recently diagnosed,,

I think your best option is to talk with this Neuro and see if either increasing your dose or adding another med is possible. Most TN patients end up on a cocktail of meds because that seems to be the most effective way to treat this....and please explain his reasoning for the Balloon compression,,,,it is really an older procedure and less effective than other options...you don't have to tell what you don't feel comfortable with just something that makes his reasoning more understandable...(thanks it's easier to give input if we understand more).

Remember there are a lot of people here who have been through it all and have great advise and input...keep coming back, we are in this with you. You can also private message anyone if you prefer. Take your B complex!! they help and let us know what we can do to help....Hang in there....Beth