Zheng Baosen, Professor and Chief Physician, Pain Department, Tianjin First Central Hospital, Director of the Pain Branch, Tianjin Medical Association Zheng Baosen, Pain Department, Tianjin First Central Hospital, Tianjin, China Trigeminal neuralgia refers to paroxysmal intolerable and severe pain in the area of distribution of the trigeminal nerve in the face. The pain area includes the facial nerve including the forehead, scalp, eyes, nose, lips, cheeks, upper jaw and lower jaw. Why would someone develop trigeminal neuralgia? First we need to recognize what trigeminal neuralgia is. Trigeminal neuralgia is one of the neuropathic pains. In 1986, the International Association for the Study of Pain (IASP) defined neuralgia as pain that is provoked or caused by primary damage and dysfunction of the nervous system, called “neuralgia”. In recent years, an article published in PAIN, the official journal of the International Association for the Study of Pain, proposed a new definition of neuropathic pain as “pain arising as a direct consequence of a lesion or disease affecting the somatosensory system”. ). What are somatosensory nerves? The nerves that emanate from the central nervous system of the human brain and spinal cord under the skin of the body are collectively called somatic nerves, and the pain caused by damage to these nerves is neuropathic pain. Therefore, trigeminal neuralgia is one of the neuropathic pains in the head and face. How does trigeminal neuralgia occur? Trigeminal neuralgia is currently considered to be a manifestation of aging in the body. For example, there are basically no cases of trigeminal neuralgia in children and adolescents, but the onset of trigeminal neuralgia occurs between the ages of 50 and 70, which is the peak of the aging stage of the human body, and the degeneration of various organ functions easily occurs during this period. For example, the degeneration of the elastic function of heart vessels is prone to myocardial infarction; the degeneration of the elastic function of brain vessels is prone to cerebral infarction; the degeneration of the elastic function of internal vessels of the nerves is prone to neurovascular infarction and neuralgia, and so on, which can be explained by a famous saying of Chinese medicine as “if it does not pass, it hurts”. There are many ways to treat trigeminal neuralgia since ancient times, including traditional medicine, acupuncture, cupping, fumigation and other methods. Modern medicine includes: oral carbamazepine (Delidor), drug peripheral nerve block, painful regional neurectomy, Gamma knife trigeminal nerve root physical excision, surgical open trigeminal nerve root decompression, etc. Recently pain physicians have discovered, after more than a decade of research, a new method of drug that can selectively block the conduction of painful nerve fibers within the ganglion, which can effectively relieve patients with trigeminal neuralgia of severe pain in the long term and also preserve the motor and sensory nerve function of the patient. This technique has been confirmed by the authors in animal experiments and clinical studies for more than ten years, and is especially suitable for patients with trigeminal neuralgia who are not significantly treated with medication and are unwilling to undergo surgical open-heart treatment. So how is this technique performed? Three conditions are required to accomplish this technical operation: first, precise guidance by multi-row CT (3D technology), second, the operator’s skillful anatomical basis and operation technique, and third, the operator’s rich experience in treatment and ability to avoid any complications. The team led by the author has learned after nearly 20 years of research and tens of thousands of cases of trigeminal neuralgia treatment that the operator must be perfect in the treatment of each patient and operate strictly step by step in order to safely and effectively relieve the pain of trigeminal neuralgia patients.