Suggest Treatment For Trigeminal Neuralgia
I read your question carefully and I understand your concern.
Regarding the MRI report I am afraid that it doesn't change much in the diagnosis. MRI (or any test) does not see trigeminal neuralgia, it is a diagnosis made based on the symptoms. What the MRI is done for is because there is a small percentage of trigeminal neuralgias which are due to something compressing the nerve such as an abnormal blood vessel or a tumor. So it is necessary to exclude such causes which might need surgery, but in most cases nothing is found.
As for whether to continue Cabamazepine...it is true that trigeminal neuralgia usually is in the form of sharp lancinating pain, but there are variations. Also at times in everyday practice there are facial pains which are difficult to classify, do not fulfill the criteria for the most well known categories. That doesn't change though that they may respond to the same treatment. Cabamazepine is used to alleviate the pain, not to cure the cause and it is effective in many other headaches apart from trigeminal neuralgia, many antiepileptics are used for pain control and prevention. Since with MRI we have excluded threatening causes (I am assuming dental causes are not suspected either) have been excluded, I do not see anything wrong in alleviating the symptoms.
So since you say it to be effective and it is a small dose which shouldn't cause much side effects, if the pain bothers you I do not see much wrong in continuing it for some time whether it is a trigeminal neuralgia form or another unclassified facial pain.
I remain at your disposal for other questions.
Thanks for your help.
PT won't help TN
If it is true trigeminal neuralgia then no, there is not much that the physical therapy or massage will do for it, it plays no role on the trigeminal nerve.
If the pain though starts in the neck and seems to spread secondarily in the head and face, then since symptoms are not typical for TN one might suspect that it is a case of the neck issue irradiating in the head and face where the physical therapy might help. If no neck pain and only in the face though it is unlikely.
Let me know if I can further assist you.