Trigeminal neuralgia is a relatively common disease in the middle-aged and elderly population, manifesting as episodes of cut-like or over-the-top pain in the face, which is intense in nature and may be triggered by washing the face, brushing the teeth or even blowing the wind, etc. The pain comes and goes suddenly and irregularly, and is completely normal when it does not hurt. There are many treatment methods for trigeminal neuralgia, and each method has its own advantages and disadvantages. Now we will compare the three most important treatment methods. Drug treatment Commonly used drugs are carbamazepine, oxcarbazepine, lamotrigine and so on. B-vitamins can be added at the same time. Advantages: low cost; non-invasive. Disadvantages: drug side effects, drowsiness, unstable walking, liver and kidney function damage. Severe allergy in individual patients. Long-term medication doses need to be increased. About 70% of patients cannot completely control their pain with medication alone. Radiofrequency treatment Through a puncture needle, the needle tip is sent to the trigeminal ganglion or a branch, and the needle tip is heated by high-frequency electromagnetic oscillation to inactivate the nerve and block the nerve conduction. Advantages: Low requirements for the patient’s physical condition, and patients of advanced age and with many comorbidities can also be treated. The operation is easy, only local anesthesia is needed, the treatment time is short, the treatment effect is immediate; even if the recurrence after the operation can still be treated with radiofrequency again. Disadvantages: lower efficiency, about 60%-70%; higher recurrence rate, about 50% at 5 years; possible combination of facial numbness, masticatory muscle weakness, corneal hypesthesia after treatment; more obvious intraoperative pain; patients with trigeminal nerve branch I pain are not suitable for radiofrequency treatment. Surgery The main treatment is trigeminal nerve root microvascular decompression surgery, through a small incision behind the ear, skull drilling, separating the vascular nerve adhesions and isolating them, to achieve the purpose of releasing the vascular compression on the trigeminal nerve. Advantages: it is the only way to completely cure trigeminal neuralgia; high efficiency, about 90%; completely normal facial sensation after surgery; general anesthesia surgery, no pain during surgery; low recurrence rate, about 5% recurrence rate in 5 years. Disadvantages: it is a general anesthesia craniotomy, with certain surgical risks, such as cerebrospinal fluid leakage, incision infection, intracranial hemorrhage, etc. It requires high physical condition of patients, and is not suitable for patients of advanced age and with many comorbidities.