Trigeminal neuralgia, sometimes referred to as “face pain,” is a recurrent paroxysmal neuralgia in the distribution of the trigeminal nerve in the face. Most trigeminal neuralgia starts at the age of 40 and occurs more often in middle-aged and elderly people, especially in women, with more attacks on the right side than on the left. The disease is characterized by sudden onset, stopping, lightning-like, slashing, burning, intractable and severe pain in the trigeminal nerve distribution area of the head and face. Patients with trigeminal neuralgia often do not dare to wipe their faces, eat, or even swallow saliva, thus affecting their normal life and work. Some people call this pain “the first pain in the world”. Classification Trigeminal neuralgia can be divided into two categories: primary (symptomatic) trigeminal neuralgia and secondary trigeminal neuralgia, among which primary trigeminal neuralgia is more common. Primary trigeminal neuralgia originally refers to trigeminal neuralgia for which no exact cause can be found. It is now believed that 80%-90% of primary trigeminal neuralgia is due to the compression of the trigeminal nerve root by tortuous and sclerotic blood vessels. Secondary trigeminal neuralgia refers to trigeminal neuralgia caused by tumor compression, inflammation, and 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. Clinical characteristics of primary trigeminal neuralgia 1. gender and age: the age is mostly above 40 years old, with more middle-aged and elderly people. There are more women than men, about 3:2. 2. Pain site: more on the right side than on the left side, and the pain starts from a point on the face, mouth or jaw and spreads to one or more branches of the trigeminal nerve, with the second and third branches being the most common, and the first branch is rare. The pain does not extend beyond the midline of the face and does not exceed the area of distribution of the trigeminal nerve. Occasionally, there is bilateral trigeminal neuralgia, accounting for 3%. 3. Nature of pain: such as cutting, stabbing, tearing, burning or electric shock-like severe and unbearable pain, or even painful. 4. Regularity of pain: the attacks of trigeminal neuralgia are often without warning, while the pain attacks are generally regular. Each pain attack lasts from only a few seconds to 1 to 2 minutes and stops abruptly. At the beginning of the disease, the number of attacks is small and the interval is long, ranging from several minutes to several hours, but with the development of the disease, the attacks become more frequent, the interval is gradually shortened, and the pain is gradually aggravated and intense. The pain attacks decrease at night. There is no discomfort during the interval. 5, triggering factors: talking, eating, washing, shaving, brushing teeth and wind blowing can trigger a pain attack, so that the patient is on tenterhooks, depressed, careful and cautious actions, and even afraid to wash their faces, brush their teeth, eat, and speak carefully, for fear of causing an attack. 6, trigger point: trigger point is also known as “trigger point”, often located in the upper lip, nose, gums, corner of the mouth, tongue, eyebrows and other places. Light touch or stimulate the trigger point can stimulate pain attacks. 7. Expression and facial changes: During the attack, it often suddenly stops talking, eating and other activities, and the painful side can show spasms, i.e. “painful spasms”, frowning and clenching teeth, opening the mouth to cover the eyes, or rubbing the face with the palm of the hand to cause local skin roughness, thickening, loss of eyebrows, conjunctival congestion, tearing and salivation. The expression is mental tension and anxiety. 8, neurological examination: no abnormal signs, a few have facial hypesthesia.