I recently had an MRI with contrast. I have bilateral facial numbness/burning sensations for about 15 months and recently started having a lot of headaches and a burning sensation through my nostrils. The MRI showed a small vascular contact with the trigeminal nerves on both sides but the neurologist said he doesn't think i have any form of TN and that the MRI findings are not relevant, essentially it is a normal MRI. How can this be? Doesn't contact between blood vessels and the trigeminal nerves indicate TN?

First let me start off by saying that I am obviously no expert on TN but from everything I have read and from my personal experience when one has TN the MRI usually comes back normal aka showing nothing abnormal on the MRI. When i had my MVD back in January Dr. Sekula found that I had a major vein twisted around my trigeminal nerve and that never showed up on the MRI/CT etc. From what i recall of my research about TN and what doctors said yes blood vessels hitting the nerve can cause this pain. I would suggest going and seeing another neurologist. No one should have to live with any form of pain & if a test is clearly showing that something is hitting of your nerve then obv something is going on. I would also request from your original neurologist the MRI on a CD to take to your next appt for the doctors to see what he found.

Best Wishes!

I agree with Sadie if the mri shows something compressing on the nerve then you need to find a new neuro for 2ed opinion bring all your records.. its your legal right to get a 2ed opinion , so use that right. can I ask what the neuro is doing for your pain are you on meds did he have any suggestions on fixing the issue? or what is the cause? do your eyes hurt also?
Keep us posted and let us know how things go. sending low pain and a wish for good rest of month.
PEACE
BMW

Thanks for the replies. It was a neursurgeon i saw and i saw him after googling for experts on TN in my local area. He is referring me to a neurologist as he says he doesn't know what the cause of the problem is, that when he initially saw me he thought i may have a brainstem lesion but this ruled out by the MRI. I don't have any eye problems. The neurologist he is referring me to has a specialist interest in headache though from what i've read this doesn't seem to fit my symptoms. I sort of am concerned that it may be a pre-TN thing, i don't have sharp pains just a numb/stinging/burning sensation which is constant.

sorry, didn't answer your enquiry about meds...have taken Lyrica 300mg for 5 weeks which made no difference, Carbamazepine 200mg for about 10 days but stopped due to getting headache and feeling tired constantly and currently i am trying Amitriptyline 20mg for about two weeks, it's made a small difference but nothing major.

Wow once again from what i have read & experienced ( i have a burning sensation on my right side which they told me is atypical TN) your symptoms sound like atypical TN. of course this is just my opinion from research on the subject. I'm not sure where you are located but I am from Pittsburgh and I saw Dr. Richard Weisman (neurologist) and Dr. Raymond Sekula ( who is now located in Erie PA as my neurosurgeon). THey took amazing care of me and my issue. Dr. Weisman was the most caring doctor I had ever met before Dr. Sekula. I would most certainly recommend either of them to see, especially Dr. Weisman because that seems to be what you need the neurologist not the surgeon just yet.

As for the medicines I am right there with you. I still have yet to find a medicine to work for my TN & nothing has made a difference at all. And if it has I couldn't tolerate it at all. & when i say couldnt tolerate I mean I would be falling asleep doing work it had that much of an impact over me.

Keep us posted! Good Luck!!