Based on your symptoms and MRI findings, this does not appear to be classical trigeminal neuralgia. Mild vascular indentation of the trigeminal nerve is a common finding and does not necessarily require surgery. I would advise you to continue the medications prescribed by your neurologist for now and monitor your symptoms. Surgery is considered only if you develop typical severe trigeminal neuralgia pain that is not adequately controlled with medications. Please follow up with your neurologist as advised, or sooner if your symptoms worsen or new neurological symptoms develop.

Usually trigeminal neuralgia pain is severe and have trigger factors which in your case are not present Its always clinical radiological correlation

You need to take tablet Mazetol 100 mg once at night for ten days following which same tablet twice daily for twenty days. If you are much better than continue same dose for 6-12 months. Surgery is required if you don’t benefit from medication or develop complications to the medication or the dose required is too high.