The medical name of the “world’s first pain” is “trigeminal neuralgia”, which is a kind of paroxysmal severe neuralgia occurring in the distribution area of the facial trigeminal nerve. Because of its sudden onset, abrupt stopping, stubborn and unbearable characteristics, patients are afraid of talking about it, which brings double torture to patients’ physiology and psychology, and some patients even have the idea of light-heartedness because of the poor effect of medical treatment and unbearable long period of pain. Modern medical research shows that the cause of trigeminal neuralgia is that the trigeminal nerve is compressed by cerebral blood vessels in the skull, resulting in local demyelination of the trigeminal nerve root, resulting in a “short circuit” between adjacent fibers in the demyelinated area. The slight tactile stimulus can be transmitted to the center through this “short circuit”, and the impulses from the center can be converted into afferent impulses through this “short circuit”, and so on, superimposed to reach the intensity above the threshold and produce the symptoms of severe pain. Trigeminal neuralgia mostly occurs in middle-aged and elderly people, with most patients starting after the age of 40 and more women than men. There are no obvious signs before the attack, and the attack lasts from a few seconds to one or two minutes. The pain can be triggered by the movement of the mouth and tongue or by external stimuli, and often has a “trigger point” (i.e., the pain is triggered by touching a part of the face), mostly in the lips, nose and inside the mouth. Chewing, swallowing, talking, washing the face, brushing the teeth and other actions can cause painful episodes. Because of the fear of causing pain, some patients do not wash their faces, speak carefully, and eat less, so that their faces are soiled, they are weak and depressed. About 60% of patients have painful episodes accompanied by tearing and drooling of the ipsilateral eye or both eyes, and occasionally uncontrollable twitching of facial expression muscles, called “painful twitching”. The pain attacks periodically, and the pain-free period is gradually shortened, and finally it seriously affects the patient’s eating and resting, which makes people feel exhausted and painful and unable to work and live normally. Trigeminal neuralgia can also cause a series of physiological activities such as respiratory system and digestive system disorders, and increase the incidence of cardiovascular disease, so patients should be treated in time to avoid delaying the disease. Toothache becomes a “scapegoat” During treatment, we found that trigeminal neuralgia is often mistaken for toothache by patients, and often the healthy teeth are extracted, or even all the teeth are extracted but still ineffective, so attention should be paid. Toothache is one of the most common symptoms of dental diseases in dentistry, mostly caused by gingivitis, periodontitis, tooth decay or fractured teeth that lead to pulp (dental nerve) infection. The pain caused by dental disease is continuous, which is very different from the intermittent and sudden stopping characteristics of trigeminal neuralgia; moreover, the severity of trigeminal neuralgia pain is much more than that of dental pain, the number of episodes is less at the beginning of the disease, and the interval is also long, ranging from several minutes, hours, to several days, with the development of the disease, the episodes are gradually frequent, the interval is gradually shortened, and the pain is also gradually aggravated and severe, which is the veritable It is the “No. 1 pain in the world”. At present, there are three treatment methods recognized by the medical profession as worthy of promotion, namely: medication, radiofrequency treatment, and minimally invasive surgery. In the early stage of the disease, some patients often choose conservative treatment, i.e. medication and radiofrequency treatment, but conservative treatment cannot be eradicated and has large side effects, such as medication can cause serious liver and kidney function damage and little efficacy; radiofrequency treatment can cause facial numbness and recur after treatment, which is also not the best choice. In contrast, minimally invasive surgical treatment is preferred for its small side effects, complete removal of the cause, and high cure rate. Minimally invasive surgery, known as microvascular decompression, was first proposed by Professor Jannatta, an American neurosurgeon, in 1967. After a small incision is made in the hairline behind the ear and the skull is drilled, the “responsible vessel”, the culprit of the disease, is isolated from the trigeminal nerve root under a microscope. Once the responsible vessel is isolated, the source of irritation disappears and the hyperexcitability of the trigeminal nerve nucleus is extinguished and returns to normal. The pain disappears immediately after surgery and normal facial sensation and function are preserved in the vast majority of patients, with no impact on work and life in the future.