I. Trigeminal neuralgia The human nervous system is divided into peripheral nerves and central nerves, of which the peripheral nerves include the cerebral nerves connected to the brain and the spinal nerves connected to the spinal cord. There are 12 pairs of nerves in the brain, and the trigeminal nerve is the fifth pair, including the sensory component that governs the sensation of the jaw and face and the motor component that governs the chewing of the mouth. Trigeminal neuralgia is a painful paroxysmal electric shock-like pain that occurs in the distribution area of the trigeminal nerve, not beyond the distribution area of the trigeminal nerve, often confined to one side, involving mostly one branch, with the second and third branches being most frequently involved. The pain is episodic electric shock-like, knife-like, or tearing-like pain, with sudden onset and sudden cessation. The pain lasts from a few seconds to tens of seconds each time. The interval between attacks is gradually shortened and the pain is gradually increased. Frequent attacks can seriously affect eating and rest. Pain attacks are often triggered by talking, chewing, brushing teeth, washing face, etc. Even wind blowing or loud sounds can cause attacks. In some patients, pain attacks can be triggered by touching the areas around the nose, mouth, gums, and the inner end of the brow arch, and these sensitive areas are called “trigger points” or “trigger points”. These sensitive areas are called “trigger points” or “trigger points”. The attack may be accompanied by twitching of the same side muscles, facial flushing, tearing and salivation, so it is also called painful twitching. The patient often rubs the ipsilateral side of the face during the painful attack, and over time the facial skin becomes rough, thickened, and the eyebrows fall off, and the patient often looks thin, haggard, unkempt, and depressed because he is afraid to eat, wash his face, and do not trim his face. The linguopharyngeal neuralgia is the ninth pair of cerebral nerves, and linguopharyngeal neuralgia is a kind of paroxysmal severe pain out of the F in the linguopharyngeal nerve division area. The pain characteristics are similar to trigeminal neuralgia, and the pain occurs at the root of the tongue, throat, tonsils, root of the ear and the back of the lower h. Sometimes, the pain at the root of the ear is the main manifestation. It is often triggered by swallowing, speaking, coughing or yawning. There are also often boarder points, mostly in the posterior pharyngeal wall, tonsils, root of the tongue, etc., and a few may be in the external auditory canal. There is no abnormality between attacks, but patients are afraid to eat for fear of inducing pain. Patients often have symptoms such as wasting, dehydration, feeling of laryngeal spasm, cardiac arrhythmia and hypotensive fainting. Facial muscle spasm Facial muscle spasm, also known as facial muscle twitch or lateral facial muscle spasm, is caused by irritation of the seventh pair of brain nerves – facial nerve. Most of them are on one side, rarely on both sides. It is characterized by tightly closed eyelids and distorted corners of the mouth, with one twitch lasting a few seconds or several minutes, with intervals of variable length. Generally, there is no seizure during sleep, but there are a few patients who twitch as usual during sleep, affecting sleep. Seizures become more and more frequent and seriously affect life and work. The etiology of trigeminal neuralgia, glossopharyngeal neuralgia and facial muscle spasm Trigeminal neuralgia, glossopharyngeal neuralgia and facial muscle spasm not only have many similarities in performance, but also in etiology. They can all be classified as idiopathic or secondary according to their etiology. The secondary ones are mostly caused by tumors or inflammatory diseases on these nerves. Those who cannot be identified as the cause are collectively called idiopathic, and most of them are idiopathic. In fact, these so-called idiopathic cases are not without an etiology. As early as 1966, the American doctor Jannetta proposed the theory of microvascular compression. In other words, the compression of these nerves at the roots of the brainstem by the tiny blood vessels that travel through them causes neurological dysfunction, resulting in neuralgia or facial twitching. This theory has been confirmed by a large number of clinical practices and has a significant impact on the treatment of these diseases. V. Microvascular decompression General anesthesia is required. A longitudinal or transverse incision is made behind the ear, about 5 cm long. a small bony window is opened behind the mastoid process, about 2 cm in diameter, the meninges are cut, the pontocerebellar angle is entered under the microscope, the place where the corresponding nerve exits the brainstem is identified, and the small vessels compressing the nerve root are carefully searched for and can be spaced out with materials such as Teflon or taping. The advantage of this procedure over other treatment methods such as radiofrequency thermal coagulation, anhydrous alcohol destruction, and botulinum toxin injection is that it targets the cause of the disease and does not destroy the integrity of the nerve. Therefore, as long as the general conditions can tolerate the surgery, it is recommended to give priority to this method, which has positive treatment effect and low recurrence rate, and in some recurrence cases, it can be treated by surgery again.