Trigeminal Neuralgia - Wind-Cold Pattern

TCM differentiation and treatment for trigeminal neuralgia

Trigeminal Neuralgia · Wind-Cold Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Head


Pattern Overview

Wind-Cold is a common pattern in trigeminal neuralgia, characterized by

**nerve demyelination causing ectopic discharge, sudden paroxysmal

facial pain, spasms, stiffness, and aggravation by cold**. The core

pathogenesis is **invasion of Wind-Cold pathogens into the facial

meridians**, causing cold contraction, Qi stagnation, and nerve

hyperexcitability.


Key Symptoms and Differentiation Points

Differentiation Dimension Manifestations
Primary Symptoms

spasms, stiffness |

Associated Symptoms

tightness |

Tongue and Pulse

floating and tense pulse |

Pathogenesis Wind-Cold pathogens invading the facial meridians
Etiology

conditioning drafts |


Acupuncture Point Prescription

Point Location Function
Fengchi (GB20)

sternocleidomastoid and trapezius | Disperses Wind-Cold and clears the

head |

Hegu (LI4)

metacarpals | Disperses Wind and unblocks collaterals |

Xiaguan (ST7)

zygomatic arch, below the temporal process of the zygomatic bone | Key

point for trigeminal neuralgia |

Jiache (ST6)

zygomatic arch, about 1 cun anterior to the angle of the mandible |

Treats facial pain |

Ashi points Tender spots on the face

meridian unblocking |

Clinical Recommendation: Filament needle, even method; moxibustion

may be added at Fengchi and Ashi points to warm the meridians. Use

gentle technique as the face is sensitive.


Herbal Formula

Base Formula: Chuan Xiong Cha Tiao San (川芎茶调散) + Ma Huang Fu Zi

Xi Xin Tang (麻黄附子细辛汤)

Composition:

Chuanxiong (Chuan Xiong), Schizonepeta (Jing Jie), Saposhnikovia (Fang

Feng), Angelica Dahurica (Bai Zhi), Asarum (Xi Xin), Notopterygium

(Qiang Huo), Mint (Bo He), Ephedra (Ma Huang), Aconite (Fu Zi), Licorice

(Gan Cao)

Action: Disperses Wind-Cold, unblocks collaterals, and relieves

pain.

Modifications

Associated Symptoms Additions/Subtractions
Severe pain Add Quan Xie, Wu Gong to search out Wind and stop pain
Severe chills Add Gui Zhi, Sheng Jiang to warm the meridians
Neck stiffness Add Ge Gen to relax sinews
Nasal congestion Add Cang Er Zi, Xin Yi to open the nasal passages
Chronic condition

unblock collaterals |


Western Mechanism Reference

Nerve demyelination causing ectopic discharge, with cold stimulation

triggering Aβ fiber abnormal discharge. Wind-Cold corresponds to

trigeminal neuralgia triggered by cold, where cold exposure lowers the

threshold for Aβ fiber discharge and triggers pain attacks.


References

1. Internal Medicine of TCM - Facial Pain with Wind-Cold.

2. Zang-Fu Pattern Differentiation: Wind-Cold → Clearing Pathway.

3. WHO. (2023). Neurological health. World Health Organization.


Explore More

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research papers and clinical case studies on TCM neurology.


Last reviewed: June 2026 | Lead author: Dr. Li Wei, DACM | Content updated: Monthly

Disclaimer: This guide is for educational purposes only and does not constitute medical advice. Consult a licensed healthcare provider before starting any treatment.