The choice of trigeminal neuralgia treatment method Each person’s disease condition is different, and the treatment method for it is also different. The specific treatment method must be decided by the relevant professional doctors, and no private medication should be used. What treatment method should be used for trigeminal neuralgia, and what kind of treatment effect should be achieved to be considered good? The following three principles should be met for the treatment. 1, the treatment method is simple, less traumatic, and easily accepted by patients. 2.Good treatment effect and small probability of recurrence in the future. 3, post-operative recovery does not affect other functional operations, and the side effects are small. There are three main methods for treating trigeminal neuralgia: medication, surgical treatment, and radiation therapy. Drug treatment: Stabilizing drugs have a good pain relief effect on the disease, blocking the transmission of synapses, thus reducing the excitability of nerve cells and playing the role of pain relief. However, long-term medication may cause side effects, mainly nausea, vomiting, dizziness, drowsiness, general weakness, etc. It is recommended to check the blood picture regularly to prevent aggravation of the damage. Surgical treatment: This type of treatment is mainly used when there is no obvious effect of drug treatment. Before surgical treatment, MRI examination is performed to confirm the compression relationship between the trigeminal nerve root and blood vessels before the next step of treatment. Surgical treatment mainly includes microvascular decompression and balloon compression. Microvascular decompression is suitable for patients with intractable trigeminal neuralgia, while balloon compression is mainly for elderly patients with weak constitution. Radiotherapy: the main clinical advocate is gamma knife treatment, which is mainly used for patients with weak constitution, no obvious effect of drug treatment, or recurrence of intractable trigeminal neuralgia, but from my experience, the domestic treatment effect is not very satisfactory. Therefore, my opinion is as follows 1. In the early stage of pain, when the symptoms are not serious, oral carbamazepine can be taken to control the symptoms. It can also be treated with trigeminal nerve branch block. 2.If the pain is severe, and the effect of medication is not good, or if the side effects of medication are not tolerated, the preferred treatment is “microvascular decompression (MVD) of the trigeminal nerve root through the posterior occipital approach”, which is the most effective treatment among all. It has the highest cure rate and low recurrence rate of all treatment modalities, and is the only modality that may preserve normal facial sensation. However, the corresponding treatment risk is also the highest, and the incidence of risk is directly related to the experience of the surgeon. Our department completes more than 200 cases of this type of surgery every year, and the cure rate of trigeminal neuralgia surgery can reach 98%. 3.If patients with poor physical condition, elderly patients, patients who cannot tolerate open surgery treatment, and patients who have a big reaction to oral carbamazepine, they can choose minimally invasive treatment with balloon compression, radiofrequency thermal coagulation, gamma knife to selectively destroy the trigeminal nerve hemianopia, balloon compression is a characteristic of our department, with high healing rate, small trauma, no pain, and low recurrence rate, but after surgery, there will be facial numbness, sensory loss, chewing weakness, and other complications. For more details, please refer to the article about health education of balloon compression on my webpage. 4. At present, our department basically chooses balloon compression according to the age of more than 75 years old, microvascular decompression surgery under 70 years old, and 70-75 years old according to the patient’s physical condition and MRI examination results.