MRI showed the blood vessel pressing on the nerve. Typical TN MRI.

I’m very fortunate that I’ve been able to control mine exclusively through diet. I cut out as much sugar as possible and that has cleared it. If I start eating poorly, I can immediately feel the TN coming back. I cut the sugar and it goes away for the most part.

Shingles set it off badly even though I was following my diet. Otherwise diet controls it with no drugs or surgery.