Unfortunately it is hard to get surgeons to perform an MVD on someone with a complicating disease like MS or Lupus. I have MS and TN and always asked my doctors if I could also have a blood vessel pressing on the nerve? They just kept blaming the pain on the MS since the MRI didn't show anything else.
I did finally get relief with a balloon rhizotomy, since I couldn't tolerate the drugs.
Continue to do your research and be your own advocate when dealing with what solutions will work for you.
I have had the MRI done. It showed no MS or anything. Of course I've read that it's very hard for them to actually see the vessel pressing on the nerve.
From what I have read, Lupus can be associated with TN pain. To be safe your doctor should check if the TN pain is caused by anything else, by performing a specialized MRI. Usually the doctors rule out everything else.