Trigeminal neuralgia is a common disease in the pain department, according to the statistics of the United States from 1945 to 1969, its incidence is 4/2.5 million per year, and it is common in adults and the elderly, accounting for 70% to 80% of patients over 40 years old, and more women than men. Trigeminal neuralgia is often confined to one or two branches of the trigeminal nerve, with the maxillary and mandibular branches being the most common. The attack is characterized by severe electric shock-like, pinprick-like, knife-like or tearing pain in the upper and lower jaws of the cheek and tongue, lasting for several seconds or 1 to 2 minutes, with sudden onset and sudden cessation and completely normal intervals. The corners of the patient’s mouth, nose, cheek or tongue are sensitive areas and can be triggered by light touch, called trigger points or trigger points. In severe cases, reflex twitching of facial muscles may occur due to pain, and the corners of the mouth are drawn to the affected side, i.e. painful twitching. The course of the disease is cyclic, and the seizures may vary from several days, weeks or months, with remission periods as normal. As the disease progresses, the number of seizures will gradually increase, the duration of seizures will be prolonged, the interval will be shortened, and even the seizures will be persistent, and they will rarely heal on their own. Neurological examinations are generally not positive. Patients are mainly afraid to wash their faces, brush their teeth, eat because of fear of pain, poor facial and oral hygiene, emaciated and depressed. The pathogenesis of the disease has not been elucidated, and most believe that there is no single cause. However, most of them are difficult to find a definite lesion, so it is thought to be related to nerve compression and demyelinating lesions. Trigeminal neuralgia treatment: drug therapy is preferred, and other therapies are used when they are ineffective or fail. 1.Pharmacological treatment Carbamazepine treatment, when the pain stops, can be considered to gradually reduce the dosage. Adverse reactions can be seen as dizziness, drowsiness, dry mouth, nausea, dyspepsia, etc. When rash, ataxia, aplastic anemia, coma, impaired liver function, angina pectoris and psychiatric symptoms appear, the drug should be stopped immediately. If carbamazepine is not effective, consider switching to phenytoin sodium. If the above two drugs are not effective, clonazepam can be tried. Adverse reactions include drowsiness and unstable gait, and occasional transient confusion in elderly patients, which disappears after discontinuation of the drug. It can be supplemented with high-dose vitamin B12, injected intramuscularly, which can relieve pain in some patients. Occasionally, there are transient dizziness, generalized itching, diplopia and other adverse reactions. 2.Closure therapy If the medication is not effective, anhydrous ethanol or glycerol can be tried to close the trigeminal nerve branches or the semilunar ganglion to destroy the sensory nerve cells, which can achieve the effect of pain relief. The adverse reaction is the loss of facial sensation in the injection area. 3.Radiofrequency electrocoagulation therapy of percutaneous semilunar ganglion The radiofrequency needle is stabbed percutaneously into the trigeminal ganglion under X-ray surveillance or CT guidance, and the radiofrequency generator is heated to make the temperature of the needle reach 65~75℃ and maintained for 1 minute. Selective destruction of unmyelinated Aδ and C fibers (conduction of pain and temperature sensation) after the hemianopia, and preservation of myelinated Aα and β thick fibers (conduction of touch sensation), the efficacy is more than 90%. It is suitable for those who are old and have systemic diseases and cannot tolerate surgery. About 20% of patients who apply this therapy have facial sensory abnormalities, keratitis, masticatory muscle weakness, diplopia, herpes zoster and other complications. 4.Surgical treatment Trigeminal nerve sensory root partial excision can be used to provide precise pain relief. Trigeminal nerve apparent microvascular decompression, pain relief without sensory and motor disorders at the same time, is a widely used surgical method, but complications such as hearing loss, air embolism and slip, spreading and temporary paralysis of facial nerve can occur. Since the etiology of trigeminal neuralgia is not clear, etiologic therapy is lacking. Internal drugs such as carbamazepine, phenytoin sodium, and nimodipine can only reduce pain attacks and have side effects. In the recently concluded National Symposium on New Advances in Clinical Pain Diagnosis and Treatment, the combination of Chinese and Western medicine and radiofrequency thermal coagulation for the treatment of primary trigeminal neuralgia was unanimously praised by the participating experts.