Spastic squint is a slowly progressive disorder that begins with neck discomfort, a “pillow drop”, neck stiffness, forced head position, and head flexion to the left or right. In severe cases, there is a shoulder lifting movement. The ear-temporal area is close to the shoulder. The neck muscles on the flexed side have high tension, and the patient feels soreness and pain, and head movement is limited. The course of the disease plateaus after several years and by itself does not usually cause the patient’s death. However, the patient’s quality of life is severely affected and extremely painful, and some patients even suffer from depression and suicide as a result. A small number of patients can heal on their own. So how to treat spastic squint? Botulinum toxin injection is a major breakthrough in the treatment of spastic squint. Most of the cases can be treated by botulinum toxin intramuscular injection and can be relieved for 3-4 months. There are also patients who do not respond to botulinum toxin treatment. Other patients have difficulty maintaining this treatment. Other medications and physiotherapy, the initial medications include anticholinergic drugs such as Benzedrine (Trihexyphenidyl) and tranquilizers such as Valium, which, when applied in high doses, can provide some relief for spastic squint, but also have significant side effects. In addition, long-term physiotherapy and biofeedback therapy may also improve the symptoms of mild spastic squint. 2.Surgical treatment (1)Indications and contraindications: ①Medication, mainly botulinum toxin injection treatment, no longer has satisfactory effect or has produced serious side effects, and surgery can be considered only 4 months after botulinum toxin treatment is ineffective. ②The duration of the disease is more than 1 year, preferably more than 3 years, and the clinical symptoms no longer progress. ③The symptoms of dystonia are confined to the neck, or at least are predominantly cervical. ④The best indications for surgery are the rotational type, the lateral contracture type and the head tilted back bilaterally. The first two are suitable for triple surgery, and the latter type is suitable for selective resection of the suboccipital muscle group. Selective peripheral nerve dissection is most satisfactory for the rotational type or its combination with mild anterior flexion or retroversion. (3) Paraneoplastic microvascular decompression: This procedure was first reported by Freckman (1981). Freckman et al. suggested that the symptoms of patients with spastic trapezius are related to vascular compression of the paraneoplastic nerve root, and its pathogenesis may be the same as that of facial spasm and trigeminal neuralgia, and the abnormal impulses of the blood vessels may be transmitted to the cervical spinal meridians through the traffic branches of the paraneoplastic nerve root, causing abnormal excitation of the cervical muscles. Only a few authors have reported that this procedure can relieve spastic squint. If the above treatment is not effective, treatment with brain pacemaker surgery (deep brain electrical stimulation, DBS) can be tried. The brain pacemaker can inhibit the abnormal impulses of the nerves in the patient’s brain, so that the symptoms can be well relieved and the patient’s ability to live and work can be restored. The procedure is minimally invasive and relatively safe, and the surgeon can adjust the parameters according to the patient’s symptoms in time after the operation so that the patient can get better results.