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 DimensionManifestations
Primary SymptomsParoxysmal facial pain, triggered by cold, spasms, stiffness
Associated SymptomsChills, no sweating, neck stiffness, facial tightness
Tongue and PulsePale red tongue with thin white coating, floating and tense pulse
PathogenesisWind-Cold pathogens invading the facial meridians
EtiologyCold exposure, facial exposure to wind, air conditioning drafts

Acupuncture Point Prescription

PointLocationFunction
Fengchi (GB20)Depression below the occipital bone, between the sternocleidomastoid and trapeziusDisperses Wind-Cold and clears the head
Hegu (LI4)Dorsum of the hand, between the 1st and 2nd metacarpalsDisperses Wind and unblocks collaterals
Xiaguan (ST7)In the depression on the lower border of the zygomatic arch, below the temporal process of the zygomatic boneKey point for trigeminal neuralgia
Jiache (ST6)In the depression on the lower border of the zygomatic arch, about 1 cun anterior to the angle of the mandibleTreats facial pain
Ashi pointsTender spots on the faceLocal pain relief and 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 SymptomsAdditions/Subtractions
Severe painAdd Quan Xie, Wu Gong to search out Wind and stop pain
Severe chillsAdd Gui Zhi, Sheng Jiang to warm the meridians
Neck stiffnessAdd Ge Gen to relax sinews
Nasal congestionAdd Cang Er Zi, Xin Yi to open the nasal passages
Chronic conditionAdd Huang Qi, Dang Shen to supplement Qi and 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.

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