Mr. Zhang is 57 years old and lives in Xinzhou, Shanxi Province. Has always been very good health, especially his appetite is particularly good “eat well”. But from last year onwards, Mr. Zhang obviously very hungry, but a mouth to eat feel like someone with a needle in the right half of his face. Every second, the pain is unbearable, after the pain, he still palpitation, careful not to eat. Over time, Mr. Zhang became increasingly thin because of malnutrition. Later, he was diagnosed with right trigeminal neuralgia in the local hospital, and tried some treatments, such as acupuncture, Chinese medicine, western medicine, and closed needles, but only for a few days before it came back, and the pain became more and more severe. I learned that this disease can be cured by surgical methods, but there were still some questions in my mind. “What is the best treatment for my case? Is there any other treatment besides surgery?” [Question and Answer] Because the diagnosis of your trigeminal neuralgia is relatively clear, the next step is to look at what causes it. First, you need to rule out secondary factors such as intracranial tumors and cerebrovascular lesions. Secondly, we need to look at the relationship between the trigeminal nerve and the blood vessels to see if there is any compression, which can be determined by an MRI of the blood vessels and nerve sequences. If it is secondary trigeminal neuralgia we have to solve the secondary factors first, primary trigeminal neuralgia treatment program is divided into two kinds, one is drug treatment, one is surgical treatment. In surgical treatment, there are two options, one is microvascular decompression and the other is minimally invasive balloon compression. The criteria for choosing which type of treatment is related to your age and tolerance for surgery, at age 57, it is recommended that you still be treated by having microvascular decompression. Microvascular decompression is a minimally invasive procedure, which is performed behind the ear, and we use a transverse incision (there is also a longitudinal incision with a relatively large wound of about 5cm), which is about three kilometers long. The surgery is basically invisible after recovery. After the surgery is done, there is no pain, and there is no after-effects, and there is no numbness in the face and other problems. So for younger patients, we tend to recommend microvascular decompression surgery for trigeminal neuralgia. Secondly, in terms of healing time, after microvascular decompression surgery, the vast majority of patients basically will not recur. The treatment of trigeminal neuralgia, including balloon compression, is also one of the more popular treatments today. Through the corner of the patient’s mouth, with a blunt needle puncture to the bifurcation of the trigeminal nerve, we put the balloon up, like a small pear, and then for compression, compression about two minutes and then removed. After the treatment the patient will have no pain, but there may be a period of time where there is a loss of facial sensation. It will also gradually recover over time. Balloon compression of the trigeminal nerve is also a better method of treating trigeminal neuralgia. It is a very suitable option for older and weaker patients. In addition to surgery, is the treatment of drugs, drugs, in addition to carbamazepine, we can also use gabapentin, pregabalin and some other drugs to relieve pain, these treatments, we can choose according to their own situation and the doctor’s advice, in the process of medication should be regularly check the liver and kidney function, for the side effects produced by the drug should be resolved in a timely manner.