Women suffer from trigeminal nerve pain incidence of the majority, so it is recommended that patients and friends early checkups, the milder patients can take medication, the more serious patients need surgical treatment. Trigeminal nerve distribution area appeared episodes of severe pain as the main manifestation; women slightly more, mostly in middle age after the onset of disease, with age and increase; pain site is often located in the unilateral, the right side of the common; distribution of the trigeminal nerve Ⅱ, Ⅲ branch of the distribution of the area is the most common, the simple Ⅰ branch of the pain is rare. (ii) Classification (1) Primary trigeminal neuralgia refers to those who have clinical symptoms, and various examinations have not found organic or functional lesions related to the onset of the disease. (2) Secondary trigeminal neuralgia is trigeminal neuralgia caused by definite lesions, and the common lesions are: (1) certain tumors, vascular malformations, aneurysms and arachnoiditis located in the pontine cerebellar angle and middle cranial fossa, among which epidermoid cysts of the pontine cerebellar angle are the most common; (2) elevated rocky bone crests, stenosis of foramen ovale or foramen ovale and other bone developmental anomalies; (3) inflammation of the trigeminal nerves, multiple sclerosis, certain organic lesions of the brainstem or the thalamus. . (iii) diagnosis (1) the clinical manifestations of primary trigeminal neuralgia ① the nature of the pain without aura of sudden lightning-like attacks, cutting, burning, pins and needles, or electric shock-like, there may be tears, salivation, facial convulsions and other accompanying movements, often with the palm of the hand tightly pressed face or rubbing, long-term facial skin on the affected side of the roughness and thickening, eyebrow hair loss, scarcity. ② pain site is limited to the distribution area of the trigeminal nerve, mostly unilateral, more on the right side, most commonly in the distribution area of the Ⅱ, Ⅲ branch, followed by the simple Ⅱ or Ⅲ branch, three branches are rarely involved at the same time, the simple Ⅰ branch involvement is also rare. Duration of pain: Each attack lasts for a few seconds or 1~2 minutes and then stops abruptly, mainly during the day and less at night. The frequency of attacks is intermittent and can be relieved on its own, and the natural interval can be several months to several years; with the prolongation of the course of the disease, the frequency of attacks increases, the degree of pain worsens, the natural interval is shortened, and even the attacks occur all day long. ⑤ Pain trigger points more than half of the “trigger points” or “trigger points”, often located in the upper lip, nose, corners of the mouth, incisors, palate, buccal mucosa, etc.; mechanical stimulation of the face, such as talking, eating, washing, brushing or wind blowing, etc. can cause attacks. (2) Secondary trigeminal neuralgia is initially a clinical symptom of primary trigeminal neuralgia, gradually appearing cerebral nerve, cerebellum and brainstem dysfunction, and in severe cases, it can be life-threatening due to increased intracranial pressure. (3) Neurological examination of primary trigeminal neuralgia neurological examination is often no positive signs; if found in the distribution area of the trigeminal nerve sensory deficits (especially corneal reflexes retarded or disappeared) or masticatory muscle weakness atrophy, facial paralysis, hearing loss and other cerebral neurological dysfunction, ataxia and other neurological anomalies, are to be considered secondary trigeminal neuralgia. (4) Adjunctive examinations CT and MRI help to clarify the nature of intracranial space-occupying lesions causing secondary trigeminal neuralgia; special sequences of MRI help to clarify the etiology of microvascular compression in trigeminal neuralgia. (iv) Differential diagnosis (1) Other neuralgia (1) glossopharyngeal neuralgia (2) intermediate neuralgia (2) cluster headache (3) secondary trigeminal neuralgia caused by tumors of the bridge cerebellar horn, etc., which can be clarified by CT and MRI, etc. (v) Treatment (1) Carbamazepine is the first choice for medication, but long-term use of the drug has the side effects of drowsiness, vertigo, and digestive disorders, and it may cause side effects such as abnormalities in liver function and lowering of white blood cells. (2) Surgical treatment of primary trigeminal neuralgia that is ineffective in drug treatment or cannot tolerate the adverse effects of drugs (the vast majority of patients with trigeminal neuralgia should have surgery? will be drug resistant after drug treatment, so more and more centers now advocate early surgical treatment). The main surgical methods include trigeminal nerve semilunar ganglion closure, posterior semilunar ganglion root thermofrequency, trigeminal nerve sensory rhizotomy, trigeminal nerve microvascular decompression and stereotactic radiosurgery, etc. However, trigeminal nerve microvascular decompression is currently recognized as the most ideal treatment, and the other treatments on the one hand, do not have a high cure rate, and on the other hand, will often cause numbness and other intolerable side effects. For secondary trigeminal neuralgia, surgical removal of the lesion is required to cure the disease.