Ms. S, a young woman from Europe, has long been tormented by the excruciating pain of trigeminal neuralgia. This pain, often described as “the most severe pain a human can endure,” has made every day of the past fourteen years a precarious walk on thin ice, forcing her to bear an agony that is hard for the average person to comprehend. In the summer of 2024, Ms. S, with hopes for the future, accompanied her Chinese husband back to Shanghai to visit family, marking her first journey to China. However, this family visit did not bring her the anticipated joy; instead, the intensification of her pain plunged her into deeper despair. “Every time I ate, washed my face, or even spoke, it would trigger intense pain,” Ms. S recalled. “I felt as if I were trapped in an endless nightmare.”

In August 2024, accompanied by her husband, Ms. S walked into Shanghai Fourth People’s Hospital, affiliated with Tongji University, carrying her last glimmer of hope. The moment she stepped into the hospital, her heart was filled with anxiety and unease, as this was yet another hospital among the countless ones she had tried over the past decade. However, the warmth and kindness of the hospital’s triage nurse instantly gave her a sense of comfort. The nurse inquired in detail about her condition, quickly arranged for various examinations, and guided her to the dental department.

In the dental department, the doctor swiftly ruled out the possibility of odontogenic pain through detailed examinations and inquiries. Ms. S was somewhat surprised, as she had been misdiagnosed with dental issues multiple times abroad. Yet here, within just a few minutes, the doctor provided a clear conclusion and suggested she visit the cardiology department, where heart disease was also ruled out. That same day, she was referred to the neurology department, and the entire process was smooth and efficient. In the neurology department, the doctor arranged for a trigeminal nerve MRI scan. The results revealed a close relationship between the root of the right trigeminal nerve and a small artery, which might be the culprit behind her long-standing pain.

The neurologist’s detailed explanation rekindled hope in Ms. S. They recommended that she visit the expert clinic of Dr. Zhang Haitao, the deputy chief physician of neurosurgery, for further evaluation and treatment. On her way to the specialist clinic, Ms. S couldn’t help but marvel at the efficiency of China’s healthcare system. Through a multidisciplinary team (MDT) approach, patients are provided with more comprehensive and accurate diagnoses. This not only effectively avoids misdiagnosis and missed diagnoses but also significantly shortens the time to diagnosis, alleviating the suffering of patients.

Finally, Ms. S reached her ultimate destination within just a few days—the consultation room of Dr. Zhang Haitao, the deputy chief physician. Dr. Zhang warmly received her and meticulously inquired about her medical history and symptoms. Ms. S felt a long-lost sense of trust and care, and she began to question her previous medical experiences abroad. Why, despite all the advanced equipment and doctors, had she never found the root of her problem? Yet here, within just a few days, she received a clear and reasonable diagnosis.

After a detailed inquiry into her medical history, it was learned that the patient had initially experienced paroxysmal pain in the right cheek area ten years ago, which gradually extended to the upper posterior tooth roots and the area in front of the ear. In severe cases, the pain could also affect the lower posterior teeth, the side of the nose, the forehead, the brow, and the temples. More than seven years ago, the left posterior upper and lower tooth roots and the cheek area also began to frequently experience pain, all presenting as intense, electric shock-like radiating pain episodes, typically lasting from a few seconds to several minutes. Trigger points were located in the right cheek, upper posterior tooth roots, the side of the nose, and the left cheek and posterior upper and lower tooth roots. Pain was often triggered by eating, brushing teeth, and washing the face. Initially, she sought treatment at the dental department of a local hospital in her home country, where two upper posterior teeth on the right side and one upper posterior tooth on the left side were extracted. Later, local dental implants were performed, but the pain persisted without relief. During this period, she repeatedly sought treatment in the pain management department and took conventional painkillers, with little effect. About three months ago, she began taking gabapentin, metamizole, and antidepressants for control, but the results were still poor, and her symptoms worsened recently. The preliminary diagnosis suggested a high likelihood of primary trigeminal neuralgia. She was advised to stop taking gabapentin and metamizole and switch to a low dose of carbamazepine for a few days to observe the effect.

“Ms. S, we will do our utmost to help you. Let’s try carbamazepine first and see how it works,” Dr. Zhang said firmly. “This is a commonly used medication, and although it has some side effects, it might be effective in the short term.”

Ms. S deeply appreciated Dr. Zhang’s sincerity and professionalism. She knew she had finally found a medical team she could trust. This smooth medical experience not only brought her hope but also filled her with respect for China’s healthcare system.

A week later, Ms. S returned for a follow-up visit and was pleasantly surprised to find that her pain had significantly alleviated. She could eat normally again, and her mental state had improved considerably. However, the side effects of carbamazepine, such as dizziness and nausea, still caused discomfort. Based on Ms. S’s condition, treatment response, and imaging results, Dr. Zhang diagnosed her with “bilateral primary trigeminal neuralgia.” Due to the long course of the disease, gradual worsening of symptoms, and significant drug side effects, Dr. Zhang recommended surgical intervention. After thorough communication with Ms. S and her husband, they decided to proceed with further treatment in the neurosurgery department of Shanghai Fourth People’s Hospital.

Three months later, on the eve of Christmas 2024, Ms. S and her husband contacted Deputy Chief Physician Zhang Haitao once again.

“Dr. Zhang, we want to return to Shanghai to continue the treatment,” Ms. S’s husband said. “In Europe, the doctors gave the same advice as you, but we trust you more.”

Ms. S’s decision to travel thousands of miles to return was a testament to her immense trust in the neurosurgery team at Shanghai Fourth People’s Hospital. Director Zhang Zhiwen instructed the entire department to integrate resources from relevant departments within the hospital to ensure the best possible care for Ms. S. Under the meticulous arrangements of Deputy Chief Physician Zhang Haitao, Ms. S completed the routine preoperative examinations and underwent a follow-up trigeminal nerve MRI scan. The results showed that the relationship between the root of the right trigeminal nerve and the blood vessels remained close, clearly indicating the need for surgery. After a comprehensive departmental discussion, it was unanimously agreed to proceed with the previously planned staged treatment approach, performing microvascular decompression surgery on the right trigeminal nerve.

On December 26th, the neurosurgery team performed the surgery on Ms. S once again. Under the guidance of Director Zhang Zhiwen, Deputy Chief Physician Zhang Haitao led the operation, assisted by Attending Physician Xu Jiaotian. The anesthesia team, led by Directors Li Cheng and Chen Guozhong, provided full support, while Attending Physician Wang Wei conducted intraoperative neurophysiological monitoring throughout the procedure. Under the microscope, the surgical team found that the vascular compression matched the preoperative MRI findings exactly. They carefully examined the area using a neuroendoscope to ensure no additional vessels were overlooked. The surgery proceeded smoothly, and upon waking from anesthesia, Ms. S immediately felt complete relief from the pain on the right side of her face.

“I feel so much lighter,” Ms. S said to Dr. Zhang. “You are amazing. I truly don’t know how to thank you enough.”

In the first two days after the surgery, Ms. S experienced intermittent headaches, but she gradually recovered as time passed. A follow-up head CT scan showed normal intracranial conditions, and her overall recovery was excellent. One week post-surgery, there was no recurrence of facial pain, and the incision healed well, allowing for the sutures to be removed. When discharged, Ms. S and her husband were beaming with happiness.

“Finally, I’ve been freed from fourteen years of suffering,” Ms. S reflected. “You not only healed my body but also reignited my hope for life.”