The difference between facial paralysis and facial muscle spasm, the etiology of the two is different, facial paralysis is mainly due to the neuroleptic virus leads to the function of the facial nerve is impaired, the patient manifests the lesion side of the facial muscle inactivity. For facial muscle spasm is mainly due to the ectopic excitation of the facial nerve leads to increased excitability of the facial nerve, the patient appeared half of the facial muscle twitch-like contraction as a characteristic, at the same time, for facial paralysis and facial muscle spasm, clinically part of the facial paralysis of the patient, can be followed by the appearance of facial muscle spasm. For the difference between facial paralysis and facial muscle spasm, the two treatments are not the same, facial paralysis in the acute stage should be given to the patient to dehydrate, reduce facial nerve edema and nutritional drugs for facial nerve treatment. Facial muscle spasm can be given to the patient’s drug treatment, can apply carbamazepine, if necessary, can be closed treatment, facial paralysis and facial muscle spasm patients can be given B vitamins, nutritive nerve drugs.