What is the difference between primary trigeminal neuralgia and secondary trigeminal neuralgia? With the rise in the number of cases in recent years, people are gradually becoming aware of this disease. But did you know that trigeminal neuralgia is also divided into primary trigeminal neuralgia and secondary trigeminal neuralgia? Etiology: Primary trigeminal neuralgia is trigeminal neuralgia where the exact cause cannot be found, which may be caused by sclerosis of the supplying blood vessels and compression of the nerves, or by thickening of the meninges and narrowing of the nerves. Secondary trigeminal neuralgia is due to tumor compression. Inflammation. Trigeminal neuralgia caused by vascular malformation. How to distinguish between primary trigeminal neuralgia and secondary trigeminal neuralgia: Carbamazepine can control trigeminal neuralgia pain attacks, so carbamazepine is used as a diagnostic drug. If the pain relief effect is not obvious or ineffective after a certain dose is tried, consider secondary trigeminal neuralgia or ask for further examination to clarify the diagnosis and exclude the possibility of misdiagnosis. Difference in age of onset: Primary trigeminal neuralgia is mostly concentrated in middle-aged people, and more women than men. Secondary trigeminal neuralgia mostly occurs in adolescents, but middle-aged people are not excluded from getting trigeminal neuralgia. The difference of concomitant symptoms: primary trigeminal neuralgia will gradually increase the number of attacks, expand the range of pain, prolong the duration of attacks, shorten the interval, and even become persistent day-long attacks as the course of the disease is prolonged. Neurological examination usually has no positive signs. It is accompanied by concomitant movements such as lacrimation, salivation, and facial twitching. Secondary trigeminal neuralgia facial concomitant neurological dysfunction, such as facial sensory deficit, masticatory dysfunction, visual impairment, etc.; concomitant limb movement disorder, headache, dizziness, vomiting, etc. are preferentially considered secondary trigeminal neuralgia. Trigger point distinction: primary trigeminal neuralgia generally has obvious pain trigger points, often located in the upper lip, nose, gums, corners of the mouth, tongue, eyebrows, tongue, ears, etc. Light touch or stimulation of trigger points may trigger painful attacks. Secondary trigeminal neuralgia has no pain trigger points and no obvious triggering factors. How to treat primary trigeminal neuralgia and secondary trigeminal neuralgia: The treatment of trigeminal neuralgia must first clarify whether it is primary trigeminal neuralgia or secondary trigeminal neuralgia. Primary trigeminal neuralgia can be treated with drugs and microvascular decompression. Microvascular decompression can completely treat trigeminal neuralgia. It is the most popular surgical treatment. In secondary trigeminal neuralgia, the disease that causes trigeminal neuralgia should be addressed first. And the treatment of secondary trigeminal neuralgia is not just treating the secondary cause. If it is due to tumor compression, the disease caused by the etiology should be addressed first. After the tumor is removed, if the vascular nerve is adhered, it still needs to be treated by microvascular decompression in order to achieve the purpose of radical treatment. In conclusion: primary trigeminal neuralgia and secondary trigeminal neuralgia have different etiologies and should be distinguished. Primary trigeminal neuralgia mostly occurs in middle-aged people, while secondary trigeminal neuralgia mostly occurs in adolescents. The symptoms of primary trigeminal neuralgia are mostly lacrimation and flow delay. Secondary trigeminal neuralgia symptoms are mostly dizziness and vomiting, etc. Primary trigeminal neuralgia has a trigger point, while secondary trigeminal neuralgia does not have a trigger point. Both primary trigeminal neuralgia and secondary trigeminal neuralgia can be treated with manifest microvascular decompression.