You might want to check out the Facial Pain Association, fpa-support.org. There is a lot of info on Trigeminal Neuralgia (TN) on that site. MVD (Micro-vascular Decompression) surgery is used in "typical" TN to move/pad a vein that is wrapped around the trigeminal nerve and rubbing against the nerve. In a large number of TN cases (typical/TN1), the vein irritates the never, causing the facial pain.

With MS, the normal cause of the facial pain is related to plaques in the brain that irritate the trigeminal nerve. An MRI is required to rule out a vein compression, tumors etc. There is a "Trigeminal Protocol MRI" using very thin slices to attempt to see vein compression; however, it is not 100% accurate.

If meds no longer work in controlling the TN, the surgical procedures I listed in my post can be considered. My post is an attempt to find more people with actual experience with Balloon Compression etc. for TN with MS.

I'm so sorry your wife has all those issues with her TM. TM was my first symptom of MS and it is well controlled with Tegretol. Hope you find a solution and you are welcome to join us here for any question or if you just want to vent. Bring your wife in in the conversation also. It's awesaome that a care giver cares enough to come on these forums.

We have the sister MS forum, The Stumble Inn for when people just want to talk about anything or just be silly. We have this MS following us around for a life time, might as well tell a few jokes and find out how to fit MS into our lives. We sure don't want our lives to fit into our MS, we want it the other way around.

TN stinks! Im sorry your wife has it. I will keep you both in my prayers.

Ohhhhh, I was thinking of only the MVD surgery, as this is the only surgery I had previously seen discussed at length for TN treatments. I can understand completely why MVD would not work for those with MS lesions being the ultimate cause of the TN.

I'm interested to hear if others have had success with those methods mentioned in your post as well.