A. What is facial muscle spasm? 1.Why do you have facial muscle spasm? Who are more likely to suffer from facial myospasm? The cause of facial muscle spasm is due to long-term compression of the facial nerve root area by blood vessels, resulting in local demyelination of the facial nerve root surface, the local nerve fibers “short circuit”, or lead to abnormal discharge of the facial nerve nucleus overexcitation, resulting in facial muscle twitching. The disease is most common in people over 45 years old, with a male to female ratio of about 1:2. 2. Why are women more likely to suffer from facial muscle spasms? It is not clear why. 3.What are the symptoms of facial muscle spasm? Facial muscle spasm typically shows intermittent twitching of the orbicularis oculi on one side, gradually extending to the orbicularis oris and facial expression muscles, and in severe cases, mild facial pain can be felt when twitching. In mild cases, the twitching can be stopped or reduced during sleep, but in severe cases, it does not stop even during sleep. Severe and prolonged cases may have mild or severe facial paralysis. Second, how to treat facial spasm? 1.What is the treatment response? When should I choose surgery? Can the cosmetic problems that surgical patients are most worried about be solved? Patients can first choose medication: carbamazepine is effective for a small number of patients with mild disease, others such as sedatives and hormones are not significantly effective. After that, botulinum toxin A can be injected intramuscularly to stop the symptoms of twitching, and the effect can be maintained for 3-4 months, after which the injection can be repeated for life, but the dose needs to be gradually increased to maintain the original effect. Finally, microvascular decompression of the facial nerve is an option. The facial nerve microvascular decompression procedure can be chosen for patients who are ineffective with Botox injections, cannot tolerate lifetime injections, or have complications with injections. Due to the high number of female patients, cosmetic issues have been fully considered. The surgery only requires shaving a small amount of hair behind the ear and making an incision of about 6cm in the hairline to complete the surgery, which does not affect the aesthetics after the surgery. 2.Do I need to take medication? What kind of medication is better to take? At present, only carbamazepine is effective for a small number of patients with mild disease, while other drugs such as sedatives and hormones have no significant effect. 3.How long does it take to recover from the surgery? What are the side effects? How can I avoid such side effects? You can usually be discharged from the hospital seven days after the surgery. Some patients may experience complications such as hearing loss and facial paralysis, which occur at a very low rate in hospitals with a high volume of surgery. If any of these complications occur, they can all be significantly improved through rehabilitation, and the incidence of permanent complications is very low. 4.After the surgery, many women are worried about leaving traces on their face. How to deal with this situation? Although facial muscle spasm is manifested in the facial muscles, the root of the disease is in the cranial brainstem where the facial nerve emanates from, so the incision position of the surgery is in the hairline behind the ear, with a length of about 6cm, in order to expose the root of the facial nerve. 5. Many patients report that there is a “buzzing in the ear” after minimally invasive surgery. Is this normal? Some patients have tinnitus before surgery, but most of them can be cured after surgery. The incidence of “buzzing in the ear” after surgery without tinnitus is about 1%. The main reason for this is that the mastoid air chamber is worn open during surgery and then closed again, resulting in changes in the air chamber connected to the middle ear; in addition, compression of the auditory nerve by the responsible blood vessel is also a possible cause. Third, can facial muscle spasm be prevented? 1. Is there any way to reduce the incidence of facial myospasm? It has been clinically observed that the frequency of seizures increases in patients with poor sleep, or high work stress and mental tension, so good work habits, adequate sleep and a calm mind can reduce the symptoms. 2. Is there anything that needs to be noted in the usual diet or lifestyle habits, especially for women? There is no clear help for dietary therapy for anterior myasthenia gravis. However, as mentioned above, maintaining good rest and sleep habits and a correct attitude towards facial myasthenia can be helpful in relieving the disease.