Patient question: disease: trigeminal neuralgia often good offense. Description of disease: trigeminal neuralgia often in July 2014, prescribed medication, and has been taking until now. Treatment process: oral nerve scratching; medication: drug name:carbamazepine, taking instructions: twice a day in the morning 3 capsules in the evening two capsules taking two years often good offender. Hope to provide help: please ask, how to treat? Reply: The cause of primary trigeminal neuralgia is currently considered by most scholars to be caused by compression of the trigeminal nerve root at the entrance of the brain bridge (REZ) and demyelinating lesions of the nerve root. For primary trigeminal neuralgia, drug therapy is still the first choice, the most effective drug is carbamazepine, but some patients have poor results, or require long-term high dose application and increasing side effects, then surgery should be considered, the common procedures are as follows: percutaneous puncture trigeminal nerve hemianoplasty, stereotactic radiosurgery, alcohol or glycerol injection, trigeminal nerve peripheral branch The best way to remove the cause of pain is to perform trigeminal nerve microvascular decompression. Trigeminal nerve microvascular decompression is to directly target the responsible blood vessels compressing the trigeminal nerve to eliminate the compressing factors and relieve the pain, with good effect, low recurrence rate, and few complications, so as to achieve the etiological treatment. With the wide clinical application of surgical microscope and neuroendoscope, the surgery has developed in the direction of minimally invasive, which can keep the function of trigeminal nerve and its surrounding structures undamaged, and microvascular decompression has become the treatment of choice for primary trigeminal neuralgia. It is recommended to do trigeminal nerve MRI to confirm the diagnosis and find the responsible vessels.