Hi, @paulamacmorgan - I imagine the trigeminal neuralgia is really painful for your brother. I wanted to let you know I moved your post here to where you were posting before so that you can interact with others or their loved ones going through similar situations. If you click on VIEW & REPLY in your email notification, you will be taken to the full discussion on this topic and be able to read what others have experienced and treatment they've pursued for trigeminal neuralgia.

Hoping that @johnbishop and also @jenniferhunter will let you know about their consult and treatment at Mayo Clinic.

Has your brother had the opportunity to meet with the surgeon who did his previous trigeminal neuralgia surgery to see what they recommend? If so, what did they say about the symptoms returning?