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Trigeminal neuralgia from compression of one of the trigeminal nerves causes pain only on one side of the face, but it’s possible to have an identical situation on the opposite side. If there's a mirror image blood vessel on the opposite side causing compression of the other trigeminal nerve, then it’s possible to have trigeminal neuralgia on both sides. Compression on one side will not give you pain on the opposite side. We recently had a woman who a couple of years ago had surgery on the right side for trigeminal neuralgia. She was relieved of the pain and then came back with pain on the left side. It didn’t respond to medication, and she underwent surgery a second time on the left side.
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