Trigeminal neuralgia is a severe painful attack on one side of the face, which is unbearable and seriously affects the quality of life, so it is called “the first pain in the world”. Traditional treatment cannot cure this stubborn disease, and can only treat the symptoms but not the root of the problem, the crux of the problem lies in the failure to find the root of the disease. After years of research, Professor Zhong Jun, chief physician of neurosurgery at Xinhua Hospital affiliated with Shanghai Jiaotong University School of Medicine, has now initially revealed the pathogenesis of this stubborn disease, and has made a breakthrough in the treatment, and patients have been satisfied with the treatment results. The reason why traditional treatment is unsatisfactory is that the root cause of the disease is not found Traditional treatment: drugs Some patients will have some relief at the beginning of the disease, but the required dose will continue to increase, and later the patient will have to terminate the medication because they cannot tolerate the side effects of the drug. In addition, these drugs are anti-epileptic drugs, which have a great impact on the central nervous system, liver and kidney function and hematopoietic system, and can cause allergies, resulting in a generalized rash, etc. Traditional treatment II: Destructive surgery Radiofrequency cautery, balloon compression, neurotomy, gamma knife, etc., are all at the expense of the sensory function of trigeminal neuralgia, and do not last long and will recur. Analysis of the etiology of trigeminal neuralgia The role of the trigeminal nerve is mainly to perceive the painful touch of the skin of the face, the oral mucosa and the tongue and cornea. For example, when the face is bitten by mosquitoes or traumatized, the trigeminal nerve will send pain signals to the brain, telling us that we are in danger, and we will make avoidance actions to avoid further damage or prompt us to see a doctor. In fact, the function of people to perceive pain is very beneficial. And by blocking the function of the trigeminal nerve, people may bite their tongue while eating, or dust may get into their eyes without knowing it, or facial burns without knowing it. So how does the trigeminal nerve work? Let’s say: when someone rings the doorbell, the wire connected to the button will transmit an electrical signal to the house bell and make a sound, telling the owner that a guest is coming, and we go to open the door. If the owner does not want to be disturbed, the button can be removed or the wire cut. This is what is done clinically with “disruption”, but the nerve fibers have a repair function and will heal after a period of time, so they relapse soon! Medication is like reducing a battery in a doorbell to reduce the ringing. After years of research and numerous experimental studies, it was found that the essence of trigeminal neuralgia is due to pathological changes in the nerve itself, not the receptors (skin of the face) – it is the short circuit of the wire, not the button. If the wires are shorted, the doorbell will ring without pressing the button! So trigeminal neuralgia is actually caused by a “short circuit” of the trigeminal nerve in the section of the brainstem where it enters the brainstem and is compressed by the blood vessels around it. Trigeminal neuralgia has the following characteristics: 1. race: more common in the East; 2. age: most people develop the disease after middle age; 3. gender: slightly higher in women than in men; 4. anatomy: almost all patients with trigeminal neuralgia have cerebrovascular compression of the trigeminal nerve root; 5. triggering factors: easy to attack when excited, anxious and other emotional tension. The reason why there are five characteristics mentioned above is as follows: the position of trigeminal nerve in the face is fixed (like a dark wire buried in the wall), while entering the cranium is relatively free and the outer membrane of the terminal nerve is thin and less resistant to abrasion (like the last section of the wire connected to the doorbell in the house, which is easily broken because there is no protective coat). Due to the anatomical characteristics of the skull base of Oriental people, especially Oriental women, the trigeminal nerve is very close to the surrounding cerebral vessels in the skull. With age, the brain tissue gradually shrinks while the cerebral vessels harden, bringing them closer to each other or even in contact with each other, and with the pulsation of the vessels, they rub against each other, causing the contact surface to break and exposing the nerve fibers. In addition, the outer membrane of the cerebrovascular wall is rich in sympathetic nerve network, which is used to control the change in the diameter of cerebrovascular vessels and regulate cerebral blood flow. However, when the membrane is broken, the sympathetic nerves of the vessel wall are exposed and come into direct contact with the trigeminal nerve fibers of the broken outer membrane, resulting in a “short circuit” of the nerves. The sympathetic nerve endings release a large amount of norepinephrine when the patient is agitated, causing abnormal impulses in the trigeminal nerve and producing pain in the face (which is actually a hallucination). As for how sympathetic nerves act on trigeminal neuralgia, this involves very complex molecular biology and electrophysiological responses. Prof. Zhong’s team is doing further research. Based on the initial clarification of the cause of trigeminal neuralgia, Professor Zhong is now treating patients mainly with minimally invasive surgery. By making a small incision in the hairline behind the patient’s ear, a hole is drilled in the occipital bone and the responsible blood vessel compressing the trigeminal nerve root is moved away under the microscope, and the patient feels the pain disappear completely immediately after the operation. This surgical method is also the most reasonable and effective treatment method available.