I am a new member and trying to learn more about Trigeminal Neuralgia. I was recently diagnosed and am taking Lyrica. I started at 100mg twice a day for about 3 weeks and had to move to 200mg twice a day about a week ago. Yesterday I had two episodes and am wondering if this is typical. From what I have read, 300mg three times a day is the maximum safe dosage and I am concerned that I will quickly get to the maximum dosage and still have pain.

My pain started about 10 months ago as a "toothache" in my right lower jaw. I went to my dentist and she referred me to a periodontist who then referred me to my neurologist. The pain typically manifests as severe pain in the right lower teeth, very similar to a toothache, but sometimes I get similar pain in the right upper teeth or right side of my face. It's like the worst toothache you can imagine and lasts for about 10-15 minutes. I sometimes have the sharp electric like pain but that only lasts 5-10 seconds.

My MRI showed an arachnoid cyst in the right cerebellopontine and cerebellomedullary angles that extends into the region of the right nerve V root entry zone. The radiologist report said "Flow-voids are identified in the region of the right cranial nerve V root entry zone which may be responsible for symptoms of trigeminal neuralgia.". My neurologist seemed to think that the arachnoid cyst might be causing the neuralgia and suggested I try Lyrica or "just live with it". I have had several friends suggest getting a second opinion from a neurosurgeon but have not done so yet. Any advice?