Trigeminal neuralgia is known as one of the most stubborn and painful diseases due to its recurrent attacks and severe pain, which seriously affects the normal life and work of patients. The various treatments for primary trigeminal neuralgia are briefly described below. For secondary trigeminal neuralgia caused by tumors, hemangiomas, cysts, inflammation, multiple sclerosis, etc., treatment also needs to be directed at the primary disease. 1, drug treatment The first choice is carbamazepine, about 70% of patients have pain relief after taking the drug, but generally it cannot be cured, the efficacy often decreases gradually and the dose has to be increased progressively, some patients (about 30%) have dizziness, drowsiness, blood white blood cell decrease, liver function damage, allergic rash and other side effects. Other drugs are phenytoin sodium, heptaerythrine, baclofen, etc., all have different degrees of efficacy, but they cannot be cured and have different degrees of side effects. 2.Radiofrequency destructive surgery This method is simple and quick, and is suitable for those who do not have good effect of medication or cannot tolerate it; those who are of advanced age, poor physical condition, cannot tolerate or are not willing to accept microvascular decompression surgery. The short-term efficacy after surgery is over 90%, but the long-term recurrence rate is relatively high (about 25%), and a few patients may have complications such as facial numbness, sensory impairment, dull corneal reflex, weakness of chewing, infection and bleeding. 3.Closure therapy usually uses anhydrous ethanol and other injections of trigeminal nerve branches to degenerate the nerve to necrosis, resulting in neurosensory impairment, the method is easy to operate, low cost, but the efficacy maintenance time is often limited, the recurrence rate is high, and can be repeatedly closed. It can be used for those who can’t tolerate or don’t want to accept surgery. 4.Jama knife treatment has the characteristics of simplicity and high safety, and is suitable for those who have poor effect of drug treatment or cannot tolerate it; those who are old, have poor physical condition, cannot tolerate or do not want to accept microvascular decompression surgery. However, the efficacy is relatively poor and the onset of effect is slow, usually starting 2 to 3 months after treatment, only 60% to 70% of those whose pain disappears after treatment, and the long-term recurrence rate is high (about 16%). A few patients have complications such as facial numbness, sensory impairment, blunted corneal reflex, and weakness of mastication after treatment. 5.Microvascular decompression At present, cranial microvascular decompression has become a treatment method with the best long-term efficacy for primary trigeminal neuralgia, especially for those who are found to have vascular compression at the near brainstem end of trigeminal nerve by preoperative cranial MRTA examination. It treats the main cause of trigeminal neuralgia, most of which is due to microvascular compression of the trigeminal nerve into the brainstem segment. Long-term relief (radical cure) can be achieved in more than 90% of patients through craniotomy microvascular decompression surgery. The surgery is performed under a microscope and requires only a small bone window of about 2,5 to 3 cm in diameter behind the mastoid process to locate the vessel compressing the trigeminal nerve, separate the vessel in question from the nerve, and place an appropriate material between them. With the increasing maturity of microsurgery technology, the safety of the operation has been improved, and the rate of postoperative complications has been very low. The rate of postoperative complications such as facial numbness, hearing loss, facial palsy, cerebrospinal fluid leakage, infection and bleeding is less than 5%, and the mortality rate is very low or close to zero, about 0.5% or less. However, it is not suitable for patients with advanced age and frailty, serious organic diseases and coagulation dysfunction. In summary, there are advantages and disadvantages of various treatment methods for trigeminal neuralgia. Generally speaking, for those who do not have good results or cannot tolerate medication, if they are in good health and have no contraindications such as serious organic diseases, microvascular decompression can be considered first, but for patients who are elderly, in poor health, cannot tolerate or are unwilling to undergo microvascular decompression surgery, other treatments such as radiofrequency disruption and Gamma knife can be used as appropriate. treatment means.