Facial muscle spasm without pain or itching is a strange neurosurgical disease. It is also because of the symptom of no pain but only twitching that many patients do not pay enough attention to it at the early stage of its onset, resulting in the condition becoming more and more serious. Although facial muscle spasm is not life-threatening, it can seriously affect daily life and work, causing great damage to the patient’s self-esteem. Analysis of the etiology of the occurrence of facial muscle spasm has a collection of many factors. There are three common clinical causes: due to sclerosis of the blood vessels, in the area of the facial nerve out of the brainstem, the blood vessels can cause compression of the nerves that cross it, and the vast majority of facial muscle spasms are due to this cause. The presence of surgical tumors such as sarcoidosis, tumors, and cysts in the brainstem region can also compress the nerve and trigger facial muscle spasms. In addition, inflammation of the facial nerve can also lead to abnormal nerve function. The latter two etiologies are less common. From the perspective of clinical symptoms, facial muscle spasm is often initially manifested as paroxysmal twitching of one side of the eye and face, and as the condition develops, it can gradually extend to twitching of the upper and lower eye and face as well as half of the facial muscles, resulting in distorted corners of the mouth and difficulty in opening the eyes, etc. The spasm mostly occurs under emotional tension and excessive fatigue. Patients can clearly feel the facial pain, which can seriously affect the patient’s vision, speech and sleep in the long run. The causes of facial muscle spasm are complex and the symptoms are varied. Patients with similar symptoms should go to a regular specialized hospital in time, combined with professional examination to confirm the severity of the disease, and actively cooperate with doctors to take appropriate treatment methods as soon as possible.