Trigeminal neuralgia is a common head and face clinical condition that has long been identified, occurring mostly in middle-aged and elderly people, more in women than in men. The onset of the disease is more on the right side than on the left side. The disease is characterized by sudden onset and termination of lightning-like, slash-like, burning-like, intractable and severe pain in the distribution area of the trigeminal nerve on the head and face, which some people call “the first pain in the world”. 1. Etiological distribution: Only when the cause of the disease is clearly identified can targeted treatment be carried out. Among all the causes of trigeminal neuralgia, 80% of the pain is caused by vascular compression of the trigeminal nerve root, while the remaining 20% of patients have tumor secondary, herpes virus infection, cerebrovascular disease, multiple sclerosis and so on. For now, the most effective test is cranial magnetic resonance imaging (MRI). For vascular compression type in the film can see which blood vessel is responsible for causing the compression and the specific location of the nerve compression; for tumor secondary type can see the size, type, texture and what important structures are around the tumor, all of which provide great help for the surgeon to make the surgical plan. 2.Corresponding treatment plan: Vascular compression type — microvascular decompression surgery to relieve vascular compression Tumor secondary type — tumor resection + microvascular decompression surgery Herpes virus type — TCM conditioning, neurotrophy, peripheral branch or hemimelia destruction Multiple sclerosis type — peripheral branch or hemimelia destruction surgery, partial severance of trigeminal nerve sensory roots 3.Early TCM conditioning: The typical onset of trigeminal neuralgia can be due to any cause. The cause of trigeminal neuralgia can be any one of them, and it is the process of gradually losing balance between pathogenic damage factors and self-repair factors. Traditional Chinese medicine and herbal medicine are characterized by the overall conditioning of the person, which can weaken the pathogenic damage factors and enhance the resistance of self-repair, so theoretically there is a possibility of healing. In particular, herpes virus type trigeminal neuralgia has a chance of self-healing within the first year through TCM conditioning and neurotrophic assistance. However, all types of trigeminal neuralgia over one year have basically lost the possibility of self-healing. 4. About carbamazepine tablets: Carbamazepine is a special drug for trigeminal neuralgia, but it can only stop the pain, not cure it. It is effective for more than 93% of patients. The domestic 100mg tablet and the imported 200mg tablet are effective for more than 93% of patients. However, patients who are allergic to carbamazepine cannot take it, and carbamazepine is toxic to liver, kidney and hematopoietic system, so you should go to hospital for blood test regularly every two to three months after taking it. And carbamazepine has drug resistance phenomenon, to achieve the same pain relief effect, the amount of drug must be increased continuously with time, so the side effects of drug dizziness and sleepiness will gradually increase until it is not tolerated. 5.Microvascular decompression: Microvascular decompression is suitable for the eradication of trigeminal neuralgia caused by various physical compression factors, and the biggest advantage is that it can remove the cause, preserve nerve function and is not easy to recur. Minimally invasive locked-hole surgery is safe, and the risk of serious complications should be less than one in a thousand under a surgeon with extensive experience. The indications for surgery are mainly limited by the risk of general anesthesia. The total cost is over twenty thousand dollars and the hospital stay is eight days. 6. Destruction treatment: Patients who are unable or unwilling to undergo microvascular decompression can opt for nerve branch/stem/ganglion destruction procedures. Specific peripheral nerve avulsion; Gamma knife of nerve root; and radiofrequency thermal coagulation, balloon compression, chemical reagent destruction by alcohol, glycerin, etc.. The advantages are the short duration of the procedure and the low cost. The disadvantages are the tendency to recur and the legacy of permanent facial, oral and tongue numbness.