1, first of all, the distribution of etiology: the etiology is not clear, it is impossible to achieve targeted and effective treatment. In terms of the etiology of trigeminal neuralgia, 70-80% of the pain is caused by vascular compression of the trigeminal nerve, while the remaining 20% of patients have tumor secondary, neuroinflammatory injury (viral and immune), and abnormal structures stuck on the nerve (meninges, neuromembranes). 2, then talk about the corresponding treatment: vascular compression type – nerve decompression surgery to lift the vascular compression; tumor secondary type – tumor resection + nerve decompression surgery; inflammatory injury type – Chinese medicine conditioning, neurotrophic, destruction surgery; abnormal jamming type – nerve decompression surgery. 3.Early TCM tuning: When typical episodes of trigeminal neuralgia first start, the cause can be any one of them, which is the result of the loss of balance between the causative damage factors and its own repair resistance factors. Traditional Chinese medicine is characterized by overall personal conditioning, which can both weaken the causative damage factors and strengthen the self-repair resistance, and theoretically has the possibility of healing. In particular, the inflammatory type of 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. Temporary carbamazepine: Carbamazepine is an effective drug for trigeminal neuralgia, but it can only stop the pain, not cure it. It is effective for more than 93% of patients. Domestically produced 100mg a piece and imported Deltamethrin 200mg a piece. 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 medicine must be increased continuously with time, so the side effects of drug dizziness and sleepiness will gradually increase until it is not tolerated. 5.Radical decompression surgery: Nerve decompression surgery is suitable for the radical treatment of trigeminal neuralgia caused by various physical compression factors. The biggest advantage is that the cause is radical, preserving nerve function and not easy to recur. The risk of complications with minimally invasive locked-hole surgery should be less than 2% under surgeons with more than 600 cases of experience with this procedure. The indications for surgery are mainly limited by the risk of general anesthesia. The total cost is $16,000 to $17,000 with an 8-day hospital stay. 6.No re-destruction: Patients who cannot or do not want to accept decompression can choose the destruction of nerve branches/stems/sections, specifically peripheral nerve avulsion; gamma focused cautery of nerve roots; trigeminal nerve hemianopia destruction including radiofrequency thermal cautery, balloon compression, chemical reagents such as alcohol, glycerin, etc. destruction. The advantage is the high safety compared to surgery, the disadvantage is the tendency to recur and the legacy of permanent facial, oral and tongue numbness.