I have MS and TN as well (TN probably was my 'onset' symptom, it was actually diagnosed long before the MS was, confirmed by various docs since).

My medications seem to keep it mostly in check, and I know my main triggers, but I still occasionally get the 'take my breath away' ice pick stabbing, shooting pain throbbing in my head/face (left side mostly, but I've had it occur bi-laterally).

Going under the knife for it, I probably wouldn't myself, but that's just my own personal experience with it. I know how to 'calm' the beast for me now, and that includes therapeutic hot bathtub soaks (I know, hot bath, MS nightmare, actually helps my TN big time!).

Thanks for the info Lady!