Some patients with primary facial muscle spasms mostly develop after middle age, and there are more women. The twitching of the orbicularis oculi muscle is the most noticeable, and in severe cases, it may even involve the ipsilateral vastus cervicis muscle, but the frontalis muscle is less frequently involved. The degree of twitching varies, and it is paroxysmal, rapid and irregular twitching. The initial twitch is light and lasts for only a few seconds, and then gradually grows for several minutes or longer, while the interval is gradually shortened and the twitches gradually increase in frequency. In severe cases, it is tonic, causing the ipsilateral eye to be unable to open, the corner of the mouth to be skewed to the ipsilateral side, and unable to speak, often aggravated by fatigue, mental tension, and voluntary movement, but it cannot imitate or control its seizure by itself. A convulsion can last from a few seconds to more than 10 minutes, with intervals of variable length. The patient feels distracted and unable to work or study, which seriously affects the patient’s physical and mental health. Most of the convulsions stop after sleep. Bilateral lateral muscle spasms are rarely seen. If there is, it often starts on both sides successively, and most of the convulsions stop on one side and then the other side seizes again, and the convulsions are light on one side and light on the other side, and bilateral simultaneous onset and convulsions have not been reported. A few patients have mild facial pain during convulsions, and individual cases may be accompanied by ipsilateral headache and tinnitus.