[Expert consensus on the diagnosis and treatment of idiopathic and secondary trigeminal neuralgia (2025 edition)].

Neurovascular compression is the primary etiology of classical trigeminal neuralgia. Microvascular decompression can achieve clinical cure by relieving the compression of responsible blood vessels on the trigeminal nerve. However, secondary trigeminal neuralgia caused by primary neurological diseases such as multiple sclerosis and tumors, as well as idiopathic trigeminal neuralgia with unclear etiology, exhibit distinct pathogenesis, diagnostic criteria, and treatment principles compared to classical trigeminal neuralgia. Due to the lack of standardized diagnostic and therapeutic guidelines for these types of trigeminal neuralgia internationally, clinical practice often faces issues such as unclear diagnosis and classification, poor treatment outcomes, and frequent complications, which have drawn significant attention from experts. Therefore, the Specialized Committee on Neurorestoratology of Chinese Medical Doctor Association, Specialized Committee on Peripheral Nerve Surgery of Chinese Medical Doctor Association, and International Association of Neurorestoratology, in collaboration with experts from neurosurgery and painology departments across 25 domestic medical centers, systematically developed 19 recommendations based on the latest medical evidence and multidisciplinary clinical experience. These recommendations address diagnosis, differential diagnosis, imaging examinations, pharmacological treatment, and surgical interventions, aiming to standardize the clinical management of trigeminal neuralgia.