Trigeminal neuralgia (TN) is considered to be one of the most painful afflictions known to medical practice. TN is a disorder of the fifth cranial (trigeminal) nerve. The typical or “classic” form of the disorder (called TN1) causes extreme, sporadic, sudden burning or shock-like facial pain in the areas of the face where the branches of the nerve are distributed – lips, eyes, nose, scalp, forehead, upper jaw, and lower jaw. The pain episodes last from a few seconds to as long as two minutes. These attacks can occur in quick succession, in volleys lasting as long as two hours. Part of the controversy that surrounds the pathophysiology of TGN is based on misquotations and inaccuracies. Against popular belief, sensory impairment in TGN—albeit small—has been documented by several groups, both using quantitative sensory testing and neurophysiological methods. As already mentioned, these changes normalize following successful MVD. Because most patients incur trigeminal neuralgia when older than 60 years, medical management is the logical initial therapy. Medical therapy is often sufficient and effective, allowing surgical consideration only if pharmacologic treatment fails. Medical therapy alone is adequate treatment for 75% of patients. Israel people around 201,390 among the total population are suffering from this disease that is 1.58% of the population effected.