Trigeminal neuralgia can occur at any age and is more common between the ages of 60-80. It is more common in women than in men. Pain is more frequent on the right side than on the left side. It is more common in the lower jaw than in the frontal area. The majority of patients with trigeminal neuralgia have small blood vessels compressing the trigeminal nerve root, but about 5% or more of patients have tumor compression as a result. Clinical symptoms manifest as episodic, paroxysmal, burning, slashing, tearing, or pinprick-like facial pain with intermittent periods as usual, with trigger points, and attacks when touching the face, brushing teeth, eating, or washing the face; patients are afraid to brush their teeth and wash their face for fear of painful attacks. Some patients may have a brief sense of near death during pain attacks. 1.Medication: The basic medication for trigeminal neuralgia is carbamazepine, which has obvious efficacy in most patients, but with the prolongation of the disease, the effect of carbamazepine gradually decreases, forcing patients to increase the dose, but with the increase of the dose, its drug side effects increase significantly, such as liver and kidney damage, nausea, dizziness, vomiting, ataxia, gait disorder and logical confusion and other side effects. The maximum daily dose is 1200 mg, but most patients have difficulty tolerating its side effects at 900 mg. Some patients who are allergic to carbamazepine and have a bleeding rash immediately after taking the drug are recommended to take gabapentin at a starting dose of 300 mg once or twice a day and increase by 300 mg every 2-3 days. 2, trigeminal nerve microvascular decompression hand: If the drug is ineffective, or the efficacy gradually decreases, and the patient’s symptoms significantly worsen, which seriously affects the patient’s work and daily life, it is recommended to implement surgical treatment. At present, microvascular decompression has become the preferred surgical treatment for trigeminal neuralgia because of the good postoperative effect and low risk. Most patients’ pain disappears immediately after surgery, with a 10-year pain-free rate of 80% and a recurrence rate of 15-20%, with recurrence occurring mostly in the first 2 years after surgery. 3.Destructive surgery, such as radiofrequency node destruction of trigeminal nerve, alcohol glycerin and other injection destruction, root destruction of trigeminal nerve in radiosurgery, balloon compression, etc. It is suitable for the elderly, patients who cannot tolerate microvascular decompression surgery, and its early efficacy is excellent, but the recurrence rate increases year by year.