The constant throbbing of the muscles of the face is facial muscle spasm, which is a slowly progressive peripheral nerve disorder in which the muscles of the human face undergo paroxysmal involuntary spasmodic throbbing twitches. The cause is an abnormal artery or vein, rare basilar aneurysm, auditory neuroma, transverse brainstem death or multiple sclerosis compressing the facial nerve root, which in turn can lead to abnormal nerve excitation or pseudo-synaptic transmission. Most patients clinically present with facial throbbing, or muscle twitching. Some patients with more severe symptoms will have a distorted mouth and eyes, tinnitus, etc., and will require additional repeat Botox injections or minimally invasive vascular decompression to relieve pressure on the nerve root area.