Who is the trigeminal nerve? The trigeminal nerve is a mixed nerve, the 5th pair of brain nerves and the thickest nerve in the face, containing both general somatosensory and specific visceral motor fibers. It controls the sensation of the face, mouth, nasal cavity and the movement of the masticatory muscles, and transmits sensory messages from the head to the brain. The trigeminal nerve is formed by the confluence of the ophthalmic (first branch), maxillary (second branch) and mandibular (third branch) branches, which innervate sensation and masticatory muscle contraction above the eye fissure, between the eye and mouth fissures, and below the mouth fissure, respectively. What is trigeminal neuralgia? Why is it called the “number one pain in the world”? Trigeminal neuralgia is a kind of recurrent severe neuralgia that occurs only in the distribution area of the trigeminal nerve in the face, and it is one of the common diseases in neurosurgery. Trigeminal neuralgia, also known as the “world’s first pain”, is a severe pain that occurs in the distribution area of the trigeminal nerve in the face, mostly spreading from the head and face, mouth and upper jaw, mostly unilateral, not exceeding the midline of the face. Sometimes the pain can be triggered by a slight touch on the nose, cheek and tongue, which are known as “trigger points”. The main characteristics of the disease are: sudden onset, stopping, lightning-like, slashing, burning, intractable and severe pain in the area of the trigeminal nerve distribution on the head and face. Clinical manifestations of trigeminal neuralgia: intense pain in one part of the face. Each attack lasts from a few seconds to 1 to 2 minutes. The pain is varied and can be tear-like, electric, knife-like or pinprick-like, and conventional analgesic drugs are ineffective. The pain can be triggered by touching a certain part of the face, mostly next to the nose, upper lip and teeth, and can be triggered by touching them, so that they dare not wash their faces, brush their teeth, cut their hair, speak loudly, or even eat, and have poor facial and oral hygiene, haggard complexion and depressed mood. Eating, talking and brushing trigger points: protective posture will gradually increase the number of episodes as the disease progresses, with longer episodes and shorter intervals, or even persistent episodes, which rarely heal on their own. How can I tell if it is toothache or trigeminal neuralgia? A significant proportion of trigeminal neuralgia is manifested as toothache, but of course, facial pain is also involved, and the teeth are also in the innervation of the trigeminal nerve. Toothache and trigeminal neuralgia are sometimes difficult to distinguish because the upper jaw is also the distribution area of the trigeminal nerve. If periodontitis and caries are not seen in dentistry, trigeminal neuralgia is more likely to be considered. In terms of the nature of pain, toothache is more persistent, while trigeminal neuralgia mostly manifests as sudden onset and stopping lightning-like pain, which can still be painful after tooth extraction. A cranial MR examination can help in the diagnosis of trigeminal neuralgia. In terms of diet, it is appropriate to eat softer foods, and for patients with chewing-induced pain, it is important to eat a liquid diet and not to eat fried foods, irritating foods, seafood products and hot foods. Patients with trigeminal neuralgia should also eat more vitamin-rich foods and foods that have a purifying and detoxifying effect. Avoid excessively stimulating movements, keep the movements gentle, soft and slow to prevent all pain triggering factors, such as washing face, brushing teeth, etc., and try to avoid stimulating the trigger point. Pay attention to keep warm in cold weather and avoid direct stimulation of the face by cold wind. To keep a happy mood, do not get angry at every turn. To establish confidence in treating the disease and actively cooperate with the doctor. To develop a healthy and reasonable routine to ensure enough sleep and rest and avoid overwork.