The trigeminal nerve is distributed on both sides of the face, usually the onset of severe pain in the area of the trigeminal nerve on one side of the face, each attack on the face like a knife cut, needle-like, tearing, burning pain, severe repeated persistent pain, often make patients suffer to life and death, in order to get rid of the pain, patients are prone to disease disorderly seeking medical treatment. There are primary and secondary trigeminal neuralgia, and the treatment is different. So how do primary trigeminal neuralgia and secondary trigeminal neuralgia differ? 1, the difference between the age of the patient: primary trigeminal neuralgia patients are mostly above 40 years old, with more middle-aged and elderly people, and the incidence can grow with age. Secondary trigeminal neuralgia patients are mostly seen in middle-aged and young people under 40 years old. 2, pain characteristics: the onset of pain in primary trigeminal neuralgia is often without warning, while pain attacks are generally regular. Each pain attack lasts from a few seconds to a few minutes and stops abruptly. At the beginning of the disease, the number of attacks is small, and the interval is long, ranging from several minutes to several hours, with the development of the disease, the attacks are gradually more frequent, the interval is gradually shortened, and the pain is gradually increased and intense. The pain attacks decrease at night. There is no discomfort during the interval. The pain of secondary trigeminal neuralgia is often persistent pain. Trigger point: primary trigeminal neuralgia has trigger points, also known as “trigger points”, which are often located at the upper lip, nose, gums, corners of the mouth, tongue and eyebrows. The pain can be triggered by light touch or stimulation such as talking, eating, washing face, shaving, brushing teeth and wind blowing. Secondary trigeminal neuralgia usually has no trigger point. 4, different etiology: primary trigeminal neuralgia mainly refers to the non-performance of neurological signs, the application of various tests can not find obvious and the onset of organic or functional lesions, for the cause of this type of pain, it is now generally believed that the trigeminal nerve sensory root into the pontocerebrum (REZ) is due to vascular pulsatile compression, the region is considered to be the intersection of the central and peripheral myelin sheath, no Chevron’s cells This area is thought to be the intersection of the central and peripheral myelin sheaths, without Schwann’s cells, and is particularly sensitive to pulsatile and transverse compressions that can produce microvascular compressions. Secondary trigeminal neuralgia is defined as having a clear etiology, and the application of various tests can reveal organic or functional lesions that are clearly related to the onset of the disease, commonly caused by medullary cavitation, brainstem vasculopathy, inflammation, tumors, and multiple sclerosis. Lesions of the anterior roots of the semilunar ganglion, the most common lesions in this area are intraorbital tumors, inflammation or tumors in the supraorbital fissure area, lesions of the cavernous sinus, inflammation or tumors of the paranasal sinuses, and odontogenic lesions, all of which can affect the roots or periphery of the trigeminal nerve. Lesions of the posterior root of the trigeminal nerve and the semilunar ganglion; lesions of the posterior root such as cholesteatoma (epidermoid cyst), auditory neuroma, meningioma, hemangioma and trigeminal nerve sheath tumor of the small pontine angle; lesions of the semilunar ganglion such as ganglion cell tumor, nerve sheath tumor, chordoma, etc.; lesions in these areas easily trigger trigeminal neuralgia symptoms and also have an effect on the nearby tissue structures, so that symptoms and signs of the corresponding areas appear. 5, different treatment: trigeminal neuralgia can be treated with carbamazepine or oxcarbazepine drugs to relieve pain, but it is not curable. To be cured, it needs to be treated for the cause of the disease. Primary trigeminal neuralgia is often treated with microvascular decompression surgery, which removes the blood vessels compressing the nerve from the pontocerebral area for treatment. Secondary trigeminal neuralgia can be diagnosed by CT, MRI, nasopharyngeal biopsy, etc., and the source of the disease can be identified and targeted treatment can be given.