In early spring, when it is still warm and cold, trigeminal neuralgia is again at its peak. Trigeminal neuralgia is a painful and unbearable condition called “the world’s number one pain”. In the 100 years since trigeminal neuralgia was named, the cause of its onset has not yet been determined, and it is even more difficult to treat. Many patients have gone through the painful process of seeking medical treatment with their faces covered. Whether it is conservative treatment or surgical treatment, the effect is unstable and there is a possibility of recurrence. So, what treatments are available for trigeminal neuralgia? And how should these treatments be chosen? The first gradient is conservative treatment, which includes medication and injection therapy for patients with the first onset of the disease within 3 months. The so-called injection therapy is the use of local anesthetic drug lidocaine mixed with vitamin-like injections injected near the painful point and the peri-trigeminal nerve trunk. Lidocaine can block pain conduction to the cranium, and vitamin-like drugs are involved in the metabolism of a variety of substances, which have the effect of maintaining the normal metabolism of the central nerve and myelinated nerves and maintaining the integrity of nerve function. The combination of the two can effectively relieve pain, especially for the first attack within 3 months of pain can achieve complete pain relief. Patients with a second attack or severe pain can also use closure therapy with oral oxcarbazepine and other drugs to achieve pain relief. Second gradient Adriamycin disruption is indicated for patients with trigeminal neuralgia attacks lasting more than three months or less than one year, especially if conservative treatment has failed. We recommend the addition of adriamycin bone hole injection treatment along with nutritional regulation of nerve function. Adriamycin injection is a chemically disruptive treatment. After injecting adriamycin into the bone foramina of the main branches of the trigeminal nerve, it can selectively destroy the corresponding trigeminal ganglion cells, which can “chemically cut” the trigeminal ganglion and block the nociceptive conduction pathway, thus suppressing the pain attack. Since no surgical incision is made, the damage to the tissues is small, and the treatment can be performed in an outpatient clinic under local anesthesia, which is easy to operate. Therefore, it is a better option to consider for patients who are ineffective in conservative treatment and cannot or do not want to receive surgical treatment. Third gradient Radiofrequency treatment Some patients with a disease duration of more than one year, after the above treatment is ineffective, can consider trigeminal nerve multipoint radiofrequency thermocoagulation. This procedure is minimally invasive, the radiofrequency needle is punctured into the location of the trigeminal nerve branches out of the skull, the electrode needle is inserted after fixing the point, the tissue impedance and square wave electrical stimulation are measured to determine the correct puncture location, then radiofrequency temperature-controlled thermal coagulation target destruction treatment can be performed, after 4 times of thermal coagulation with different temperature gradients, the pain in the area innervated by this nerve disappears and is replaced by different degrees of numbness. Compared with other procedures, the multi-point radiofrequency method for trigeminal neuralgia is less invasive, has shorter operation time, less complications, reliable and ideal treatment method. This treatment belongs to the third gradient. Fourth gradient: Radiofrequency treatment + Adriamycin injection + nerve avulsion This method is mainly aimed at a small number of patients with repeated attacks, severe pain, serious impact on the quality of life and other treatment methods are ineffective. Our program is “comprehensive treatment”, which can block the trigeminal nerve sensory fibers to receive and transmit nociceptive sensation more completely, and this procedure is slightly more traumatic than the above treatment, but generally patients can tolerate it; the patient’s numbness lasts longer after the operation, but the numbness is a tolerable option compared with severe pain. This is the fifth gradient. Fifth gradient Craniotomy This belongs to the category of neurosurgery and has good results. However, it requires craniotomy, which is dangerous and occasionally fatal. About 90% of trigeminal neuralgia patients can achieve pain relief or complete pain relief after appropriate treatment. However, according to clinical data, realistically speaking, there are still 10% of patients who, despite all efforts, still cannot achieve the expected results. Moreover, according to clinical statistics, about 20% of patients who are cured will relapse and need to undergo surgery again. In fact, the desire of doctors and patients is the same, that is, “the patient is cured”. However, due to the development of medicine and the individual differences of the disease, the wish of partial cure is sometimes not achieved. Therefore, on the way to cure trigeminal neuralgia, we still need the hard and unremitting efforts of clinicians and basic medical researchers. We believe that one day, mankind can always find a cure for trigeminal neuralgia.”