Patient Question: Hello doctor, my mother often feels pain in her face, which comes and goes, and in severe cases she is afraid to speak, brush her teeth, or open her mouth to eat. Now she can neither go out to work nor rest quietly, and her whole body has become thin, lethargic and very painful. When she visited our local hospital, the stomatologist said she had toothache and had several teeth extracted; the neurologist also said it was trigeminal neuralgia. Doctor: Hello, this patient. To explain your mother’s disease clearly, we need to start with the innervation of the face. As the picture below shows, the sensation of the skin on each person’s face is governed by a nerve that emanates from the brain. The name of this nerve is the “trigeminal nerve”. After this nerve is emitted from the brain, it is divided into three branches, which are distributed to the upper, middle and lower areas of the face (corresponding to the areas represented by ①②③ in the picture below). Our facial skin is sensed by our brain through the transmission of the trigeminal nerve for various sensations such as external touch, hot and cold temperature, pain and itching. Some lesions on the trigeminal nerve (may be blood vessels, tumors, viruses, etc.) may cause abnormalities in facial sensations, the most common abnormality being pain. The most common abnormality is pain. This pain has similar typical characteristics, so the medical community has named it “trigeminal neuralgia”. Sometimes dentists misdiagnose trigeminal neuralgia as toothache because the pain is located in the tooth socket. There are some simple ways for patients to determine if they have trigeminal neuralgia. For example: (1) Does the patient feel pain in the unilateral cheek, forehead, jaw, upper and lower alveoli, nose, lips, or eye socket? (2) Can the pain be described as “cutting, lightning, burning, pins and needles, or severe pain”? (3) In the early stage of the disease, does the pain pass by in a flash, usually not more than two minutes; however, as the disease lengthens, the number of episodes becomes more frequent and the pain lasts longer and longer? (4) Is the pain suddenly triggered by opening the mouth, talking, brushing the teeth, eating, washing the face, or touching the facial skin? (5) If the patient’s local hospital doctor has prescribed the drug “carbamazepine”, will the patient’s pain be relieved (at least for a short time) after taking it? If you or your family member’s pain meets 3 (or more) of the above descriptions, then it is likely that you are suffering from “trigeminal neuralgia”. Of course, your self-diagnosis by referring to the above description is only a preliminary judgment, and you will need to go to a neurosurgery clinic and ask an experienced doctor to confirm your diagnosis.