Some facial spasms require surgery. What should I do if I can’t have surgery right away for my own reasons, but I want to relieve the symptoms? Is there any specific medicine? Is Botox effective? If the facial muscle spasm is obvious and affects daily life and work, you can take some B vitamins or other nerve-nourishing drugs such as methylcobalamin and adenosine glutamine under the guidance of a doctor; if the eyelids and corners of the mouth twitch particularly hard, you can inject Botox type A to temporarily relieve the spasm for a certain period of time. However, these drugs are also only nourishing nerves and do not solve the most immediate problem, while the current spasm-relieving drugs for facial spasm are not particularly good, such as carbamazepine, which is a Na+ channel blocker that can slow down the transmission of nerve electrical signals in all cells, especially a prevalent channel in the cell membrane that transmits nerve electrical signals – -Na+ channels, thus slowing the transmission of nerve electrical signals to the muscles and the transmission of muscle twitches to the sensory centers of the brain (see figure below). However, because the drug is not directed, it can slow down all the nerve signals and patients can experience side effects such as drowsiness and unresponsiveness. For some patients who drive a lot, it is recommended to avoid using carbamazepine as much as possible. Massage, physiotherapy, acupuncture, and buried threads are not exactly effective for facial muscle spasm and are therefore not recommended. In fact, the two most effective methods for treating facial spasm are botulinum toxin injection and microvascular decompression. Botox treatment can be used when the patient has mild symptoms, is more apprehensive about surgery, and wants to relieve symptoms through a minimally invasive approach. A small amount of botulinum toxin has the effect of wrinkle removal and is usually more common in some cosmetic institutions, but this dose does not play a role in treating facial muscle spasm; a large dose of botulinum toxin can cause facial paralysis; only the right amount of botulinum toxin can effectively treat facial muscle spasm. The principle of botulinum toxin type A in treating facial myasthenia is also based on the principle of facial myasthenia. When the “blood vessel” is in close contact with the facial nerve, the blood vessel is constantly pulsating, which causes the facial nerve to continuously issue impulses, which are transmitted to the facial muscles, causing the facial muscles to constantly twitch, and the sensory nerves of the facial muscles feed the twitching phenomenon to the cerebral cortex, and the patient feels uncomfortable with the face. Botox acts on the neuromuscular junction, the site where nerves and muscles come into contact and transmit electrical signals to nerves, weakening the impulses transmitted from nerves to muscles, thus reducing the twitching and discomfort of the facial muscles (see figure below). This method prevents facial twitching by sacrificing the motor function of the facial muscles, which can be called “fighting poison with poison”. However, if the facial paralysis is more severe, it may be due to the over-injection of Botox, but as the Botox is absorbed and metabolized, the facial paralysis will slowly improve, and the dosage should be reduced for the next application. Botox can be injected in any twitching area of the face at a fixed point, such as at the eyelid for eyelid jumping, at the corner of the mouth for mouth jumping, etc. Local Botox injections will not harm the function of other nerves. The needles used for Botox injections are so small that the eye of the needle is basically invisible after the injection, so there is no need to worry about leaving scars on the face. Botox is 900 RMB/injection and 1-2 injections are needed each time to treat facial muscle spasm. The effect can be seen with one Botox injection, but because Botox does not treat the underlying cause, the effect can only last 3-6 months as Botox is metabolized, so it will definitely relapse after a period of time. After a relapse, you can have another injection, or you can have surgery to treat it completely. Botox injections are a way to temporarily relieve the symptoms and provide some time to schedule surgery, although they do not cure the problem.