Trigeminal neuralgia, known as the “world’s first pain”, is a discharge-like, knife-like pain that occurs in the face, causing pain when brushing the teeth, washing the face, talking, or even swallowing saliva, which seriously affects the patient’s confidence in normal work and even life. The pain is paroxysmal and lasts for a few seconds or minutes. The incidence of trigeminal neuralgia is high, mostly after the age of 40, with more women, and the incidence is about 50 per 100,000. Trigeminal neuralgia is divided into two types: “primary” and “secondary”. I. Primary trigeminal neuralgia cannot find the exact cause, and is more common. Clinical characteristics: sudden onset, mostly on one side. The pain is as severe as knife or electric shock and lasts for several seconds to 1-2 minutes, often accompanied by facial muscle twitching, lacrimation, drooling, facial flushing, conjunctival congestion, etc. As the condition worsens, the interval becomes shorter and the attacks become more frequent. 1, gender and age: the age is more than 40 years old, with more middle-aged and elderly people. There are more women than men, about 3:2. 2. Pain site: more on the right side than on the left side, the pain starts from a point on 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 is 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.The nature of pain: such as inverted cutting, needling, tearing, burning or electric shock-like severe and unbearable pain, or even painful. 4.Pain pattern: The attack of trigeminal neuralgia is often without warning. 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, but as the disease develops, the attacks become more frequent, the interval is shortened, and the pain becomes more severe. The pain attacks decrease at night. There is no discomfort during the interval. 5, triggering factors: talking, eating, washing, shaving, brushing teeth and wind blowing can trigger a pain attack, so that the patient is in a panic, depressed, careful and cautious actions, for fear of causing an attack. 6, trigger point: trigger point is also known as “trigger point”, often located in the upper lip, nose, gums, corner of the mouth, tongue, eyebrows and other places. Light touch or stimulate the trigger point can stimulate the pain attack. 7. Expression and facial changes: During the attack, it often suddenly stops talking, eating and other activities, and the painful side can 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 to cause local skin roughness, thickening, loss of eyebrows, conjunctival congestion, tearing and salivation. The expression is in a state of mental tension and anxiety. Secondary trigeminal neuralgia Secondary trigeminal neuralgia is also called 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 lighter, the duration of pain episodes is longer, or it is persistent pain with paroxysmal aggravation. It is mostly seen in middle-aged and young adults under 40 years of age, usually without a trigger point and with no obvious precipitating factors. Sometimes the secondary trigeminal neuralgia attacks are very similar to the primary trigeminal neuralgia and can be easily misdiagnosed if the subtle early manifestations of the secondary lesion are not noted. Usually CT and MRI of the head can detect the primary disease.