The clinical manifestations of trigeminal neuralgia are very characteristic. If you experience recurrent episodes of severe unilateral facial tearing and pins-and-needles pain, you should consider whether you have trigeminal neuralgia. Trigeminal neuralgia usually comes on suddenly, often triggered by actions such as chewing, brushing teeth, washing face, talking or even opening mouth (called trigger points), and the attack time varies from seconds or minutes to hours, while the inter-episode period is completely normal, and severe cases may be accompanied by muscle twitching, tearing, salivation and runny nose. Many patients are afraid to eat, wash their faces, brush their teeth and talk because of the fear of pain, which seriously affects their normal life and even makes them suffer from pain. The diagnosis of trigeminal neuralgia is mainly based on clinical manifestations, and it is often easy to make a judgment based on typical symptoms, but some patients treat trigeminal neuralgia as “toothache” and still have pain after tooth extraction, and some have acupuncture, take Chinese medicine, and some take painkillers, and finally they have no choice but to go to the hospital. Therefore, we advise our patients to go to a regular hospital for treatment once they have recurrent unilateral facial pain. The next step is not to rush to take medicine, but first to figure out the cause of the disease. At present, it is generally believed that it is due to the compression of the trigeminal nerve root by blood vessels leading to demyelinating lesions forming a short circuit in nerve conduction. Some patients are caused by other cranial diseases, such as tumors, cysts, inflammation, etc., which are called secondary trigeminal neuralgia. Therefore, patients with trigeminal neuralgia should undergo cranial magnetic resonance imaging (MRI) and CT examinations before treatment to exclude and treat these lesions. For patients with new onset of trigeminal neuralgia, oral medications such as carbamazepine, lamotrigine tablets and other antiepileptic drugs are usually used, but the effect is significant in the short term, but over time, the efficacy of the drugs will become less and less effective, and will cause liver and kidney damage, which often outweighs the loss. Professor Sun Hongtao has cured more than 2000 patients with trigeminal neuralgia and facial spasm since he started microvascular decompression, and has accumulated valuable clinical experience.