Neuralgia is rated nine on the pain scale and is a “very intense pain”. Let’s introduce a type of neuralgia that occurs in the face, namely trigeminal neuralgia, which describes pain that is lightning-like, knife-like, burning, persistent, and intolerable. Trigeminal neuralgia usually occurs in the trigeminal nerve area on one side of the face, but is rare bilaterally, with sudden onset and stop, and repeated attacks, and can be triggered by talking, washing, brushing teeth or wind blowing on the face, or even walking, which greatly affects the work and life of patients. So what causes trigeminal neuralgia? What methods can be used to cure trigeminal neuralgia completely? According to the classification of causes, trigeminal neuralgia can be divided into two categories: primary and secondary, among which primary trigeminal neuralgia is more common. Primary trigeminal neuralgia refers to trigeminal neuralgia where the exact cause cannot be found. It may be caused by sclerosis of the supplying blood vessels and compression of the nerve, or it may be caused by thickening of the meninges and narrowing of the bony foramen through which the nerve passes, resulting in compression. Secondary trigeminal neuralgia refers to trigeminal neuralgia caused by tumor compression, inflammation, or vascular malformation. This type differs from the primary one in that the pain is often persistent and signs of lesions in the adjacent structures of the trigeminal nerve can be detected. The initial diagnosis of trigeminal neuralgia can be treated with medication, generally the preferred drugs are carbamazepine, oxcarbazepine, etc. About eighty to ninety percent of patients can achieve effective relief, and a small number of patients cannot tolerate adverse drug reactions. If trigeminal neuralgia is severe and the effect of drugs is not good, surgery can be considered to diagnose whether it is primary or secondary through some auxiliary tests, and then do specific treatment. Most patients with clinical trigeminal neuralgia are primary, caused by adhesions or compression of the trigeminal nerve root and intracranial blood vessels. Firstly, microvascular decompression is performed, which refers to the application of microsurgical techniques to remove the blood vessels compressing the nerve and place decompression materials between the nerve and blood vessels to achieve the disappearance of facial pain after surgery. Microvascular decompression does not cut the nerve, preserves the integrity and physiological function of the trigeminal nerve, and preserves facial sensation after surgery. Because microvascular decompression for trigeminal neuralgia has few complications and helps to protect the nerve function.