Trigeminal neuralgia can be divided into two categories: primary (symptomatic) trigeminal neuralgia and secondary trigeminal neuralgia, with primary trigeminal neuralgia being more common. Primary trigeminal neuralgia refers to trigeminal neuralgia in which the exact cause cannot be found. Secondary trigeminal neuralgia refers to trigeminal neuralgia caused by tumor compression, inflammation, and vascular malformation. This type differs from primary in that the pain is often persistent and signs of lesions in the adjacent structures of the trigeminal nerve can be detected. Primary The etiology and pathogenesis of primary trigeminal neuralgia are unknown, but most believe that the lesions are in the periphery of the trigeminal nerve, i.e., within the sensory roots of the trigeminal hemimelia. Based on microsurgical and electron microscopic observations, it may be associated with small vascular malformations, bony malformations in the rocky bone area, and other factors that cause painful episodes. It is generally believed that the diagnosis of trigeminal neuralgia should have the following characteristics: 1. Gender and age: the age is mostly above 40 years old, with middle-aged and elderly people being the most common. The pain is more frequent in women than in men, about 3:2. 2. Pain location: more on the right than on the left side, and the pain starts from a certain point of the face, mouth or jaw and spreads to one or more branches of the trigeminal nerve, with the second and third branches being the most common, and the first branch being rare. The pain does not extend beyond the midline of the face and does not exceed the area of distribution of the trigeminal nerve. Occasionally, there is bilateral trigeminal neuralgia, accounting for 3%; 3. Nature of pain: such as backward cutting, stabbing, tearing, burning or electric shock-like severe pain, or even unbearable pain; 4. Regularity of pain: the onset of trigeminal neuralgia is often without warning, while the onset of pain is generally regular. Each pain attack lasts from only a few seconds to 1 to 2 minutes and stops abruptly. At the beginning of the disease, the number of attacks is small, and the interval is long, ranging from several minutes to several hours, with the development of the disease, the attacks become more frequent, the interval is gradually shortened, and the pain is gradually increased and intense. The pain attacks decrease at night. There is no discomfort during the interval; 5. Trigger factors: talking, eating, washing face, shaving, brushing teeth and wind blowing can trigger painful episodes, so that patients are depressed, act cautiously, even afraid to wash face, brush teeth, eat, and speak carefully for fear of causing an attack; 6. Trigger point: trigger point is also called “trigger point”, often The trigger point is often located on the upper lip, nose, gums, corners of the mouth, tongue, eyebrows and so on. 7. Expressions and facial changes: during the attack, the person often suddenly stops talking, eating and other activities, and the painful side may show spasms, i.e. “painful spasms”, frowning and clenching teeth, opening the mouth to cover the eyes, or rubbing the face with the palm of the hand, resulting in local skin roughness, thickening, loss of eyebrows, conjunctival congestion, tearing and salivation. Tearing and salivation. Neurological examination: no abnormal signs, a few have facial hypesthesia. Such patients should have further medical history, especially if they have a history of hypertension, and a comprehensive neurological examination, including lumbar puncture, skull base and internal auditory tract radiography, cranial CT, MRI, etc., if necessary, to help differentiate from secondary trigeminal neuralgia. Secondary Secondary trigeminal neuralgia is also known as symptomatic trigeminal neuralgia. It is trigeminal neuralgia caused by various intracranial and extracranial organic diseases. It appears similar to primary trigeminal neuralgia in facial pain episodes, but its pain level is milder, the duration of pain episodes is longer, or the pain is persistent and worsens in paroxysms. It is most often seen in middle-aged and young adults under 40 years of age, usually without trigger points and with no obvious precipitating factors; a few may reveal areas of trigeminal nerve damage and features of primary disease manifestations. Brain crest fluid, X-ray skull base radiograph, CT or MRI examination, and nasopharyngeal biopsy are helpful for diagnosis. Sometimes the attacks of secondary trigeminal neuralgia are very similar to primary trigeminal neuralgia and can be easily misdiagnosed if subtle early manifestations of secondary lesions are not noted. There are many diseases that cause facial pain, both extracranial and intracranial, vascular and neurological diseases can cause facial pain. As the disease worsens, the intervals become shorter and the attacks become more frequent, and after an intense pain stimulation, the patient becomes abnormally nervous and causes great pain.