Trigeminal neuralgia, also known as painful twitching, occurs mostly on one side of the face and presents as a recurrent, transient paroxysmal sharp pain within the trigeminal nerve distribution of the face. Its incidence is 3.4 per 100,000 men and 5.9 per 100,000 women, with the highest incidence during the age of 50-70. Because of the frequent facial pain, it causes great pain to the patient’s body, mind, and daily life and work. Trigeminal neuralgia is generally divided into two types: primary and secondary. Secondary trigeminal neuralgia refers to facial pain caused by compression or stimulation of the trigeminal nerve due to clear causes, such as tumors, vascular lesions and skull base malformations, etc. Treatment is based on removing the primary lesion. This article focuses on primary trigeminal neuralgia. Primary trigeminal neuralgia is often confined to one or two branches of the trigeminal nerve, with the maxillary and mandibular branches being the most common. The attack is characterized by severe electric shock-like, pinprick-like, knife-like or tearing pain in the upper and lower jaws of the cheek and tongue, lasting for several seconds or 1 to 2 minutes, with sudden onset and sudden cessation and completely normal intervals. The corners of the patient’s mouth, nose, cheeks or tongue are sensitive areas and can be triggered by light touch, called trigger points or trigger points. In severe cases, reflex twitching of facial muscles may occur due to pain, and the corners of the mouth are drawn to the affected side, i.e. painful twitching. The course of the disease is cyclic, and the seizures may vary from several days, weeks or months, with remission periods as normal. The number of seizures will gradually increase as the disease progresses, the duration of seizures will be prolonged, the interval will be shortened, and even the seizures will be persistent and rarely heal on their own. The neurological examination usually has no positive signs. Patients mainly show that they are afraid to wash their faces, brush their teeth and eat because of the fear of pain, and have poor facial and oral hygiene, emaciated face and depressed mood. The main treatment methods are as follows: 1. Drug treatment Carbamazepine treatment, when the pain stops can be considered to gradually reduce the dosage. Adverse reactions can be seen as dizziness, drowsiness, dry mouth, nausea, dyspepsia, etc. Immediate discontinuation is required when rash, ataxia, aplastic anemia, coma, impaired liver function, angina pectoris, and psychiatric symptoms appear. If carbamazepine is not effective, consider switching to phenytoin sodium. If the above two drugs are not effective, clonazepam can be tried. Adverse reactions include drowsiness and unstable gait, and occasional transient confusion in elderly patients, which disappears after discontinuation of the drug. It can be supplemented with high-dose vitamin B12, injected intramuscularly, which can relieve pain in some patients. Occasionally, there are transient dizziness, generalized itching, diplopia and other adverse reactions. 2.Closure therapy If the medication is not effective, anhydrous ethanol or glycerol can be tried to close the trigeminal nerve branches or the semilunar ganglion to destroy the sensory nerve cells, which can achieve the effect of pain relief. The adverse reaction is the loss of facial sensation in the injection area. 3.Radiofrequency electrocoagulation therapy of percutaneous semilunar ganglion The radiofrequency needle is stabbed into the trigeminal ganglion percutaneously under X-ray surveillance or CT guidance, and the radiofrequency generator is heated to make the temperature of the needle reach 65~75℃ and maintained for 1 minute. Selective destruction of unmyelinated Aδ and C fibers (conduction of pain and temperature sensation) after the hemimelia, preserving myelinated Aα and β thick fibers (conduction of touch sensation), with an efficacy of more than 90%. It is suitable for those who are old and have systemic diseases and cannot tolerate surgery. About 20% of patients who apply this treatment have facial sensory abnormalities, keratitis, masticatory muscle weakness, diplopia, herpes zoster and other complications. 4.Surgical treatment Trigeminal nerve sensory root partial excision can be used to provide precise pain relief. Trigeminal nerve apparent microvascular decompression, pain relief while not producing sensory and motor disorders, is a widely used surgical method, but complications such as hearing loss, air embolism and slip, spreading and temporary paralysis of facial nerve can occur.