There are several studies that have successfully linked trigeminal neuralgia (TN) to genetics. One such example is the one attached below. From what I've read, TN usually occurs spontaneously, but is sometimes associated with facial trauma or dental procedures. In fact, lots of people have the compressed nerve and never develop any symptoms. There is also the possibility that the TN is being compressed by an artery or vein due to which it is malfunctioning. But, for the most part, the exact pathophysiology of how vascular compression leads to TN remains speculative. People with multiple sclerosis usually develop TN. Multiple sclerosis is a condition in which the myelin sheath surrounding the nerve degenerates, leaving the nerve unprotected, but I don't want you to freak out over this as I'm just stating every single possibility.
Thanks for the info. I wonder what genetic markers there are since it is fairly rare. Like 1/100th of a percent in the U.S.
Also what exactly causes a blood vessel to put pressure on the nerve? Can't the blood vessel be removed or simply moved aside? My understanding is they use a tephlon pillow to put space between the nerve and blood vessel in one surgical procedure, but why do that? Are they so sure if they don't put a artificial barrier in there that it will reoccur or something? It doesn't sound like the initial cause is well known.