Trigeminal neuralgia behind the ear. It is possible that this is not trigeminal neuralgia because the trigeminal nerve does not innervate this area. The trigeminal nerve is the fifth of the twelve pairs of brain nerves in the body and is the largest pair of brain nerves. It has three branches that innervate the various senses of the face: the ophthalmic branch, the maxillary branch and the mandibular branch, of which the second and third branches innervate the area most commonly invaded by trigeminal neuralgia. If a patient has trigeminal nerve pain behind the ear, the pain is usually caused by the compression of the trigeminal nerve root by blood vessels. The episodes of pain are brief, usually within a few seconds to a few minutes, rarely exceeding five minutes, and there is often no pain at all between episodes, or at most a mild dull ache. Most of the pain behind the ear is caused by auriculotemporal neuralgia, which is a non-specific inflammatory disease. It may also be caused by a combination of cervical spine problems, so this time we need to clarify the cause, to see whether the cervical spine factors dominate, or trigeminal neuralgia dominates. Then we will do a diagnostic treatment in the outpatient clinic, which is to stick a needle in the area behind the ear where the nerve comes out. Then we give some local anesthetic to see if this pain will go away, so as to determine whether there are more factors coming from the cervical spine or whether there is a problem with the trigeminal nerve itself. After we have clarified which of these two causes is dominant, then our treatment is to do some minimally invasive interventions to eradicate the cause. However, it cannot be excluded that the patient has trigeminal neuralgia behind the ear and the lesion involves the maxillary branch of the trigeminal nerve, and then the patient needs timely treatment. Patients with trigeminal neuralgia can be treated with antiepileptic drugs if there are no contraindications, and carbamazepine or oxcarbazepine are more commonly used in clinical practice. To relieve patients’ pain and improve their quality of life. Therefore, trigeminal neuralgia treatment should be chosen from regular public hospitals, suitable for patients, and according to the cause of trigeminal neuralgia, they should receive treatment of apparent microvascular decompression, which is internationally recognized as the only treatment method according to the cause of the disease. And through years of clinical feedback, it is found that the effect of microvascular decompression in the treatment of trigeminal neuralgia is exact, and the pain symptoms disappear immediately after the operation, and the recurrence rate is low and the complications are few, so it has become a treatment for trigeminal neuralgia with remarkable effect.