Facial spasm is common in middle-aged and elderly people, manifesting as involuntary twitching of one side of the face, and is a common neurosurgical condition. Currently, intracranial vascular compression of the facial nerve is considered to be the cause of facial myospasm. Diagnostic symptoms of facial muscle spasm: 1, the site of twitching: the initial stage of the disease is mostly one eyelid, gradually and slowly expand to one side of the face, the face and the corner of the mouth muscle twitching, serious cases can involve the neck muscles. With the prolongation of the disease, the eyes on the same side cannot be opened and the corners of the mouth are skewed to the same side. Bilateral lateral muscle spasms are rare, mostly on one side of the disease, and gradually develop to both sides. 2, the characteristics of the convulsions: the degree of convulsions vary, for paroxysmal, irregular convulsions. The initial convulsions are light and last only a few seconds, and then they gradually increase and can last for several minutes or longer; most of the convulsions stop after sleep. It is often aggravated by fatigue, nervousness, and voluntary movements, but cannot control its onset. Patients feel distracted, unable to work or study, or even unable to open their eyes or walk, which seriously affects their physical and mental health. 3.Concomitant symptoms: individual cases may be accompanied by ipsilateral dizziness, tinnitus and lacrimation. 4.Facial myospasm examination means: magnetic resonance examination: the presence of blood vessels compressing the facial nerve is clarified by imaging examination (MRTA), and the presence of intracranial lesions is also clarified. Electrophysiological monitoring: abnormal muscle potential waveform (AMR) exists in patients with facial myospasm, which is specific to facial myospasm. In contrast, AMR waveforms cannot be monitored in normal populations. Treatment: 1. Drug therapy: There is no ideal treatment drug, and drugs such as carbamazepine and oxcarbazepine can be used; drug therapy is less effective and side effects will gradually appear with the prolongation of the disease. During the course of drug treatment, pay close attention to the side effects of the drug. Carbamazepine may cause symptoms such as rash, drowsiness, unresponsiveness and unsteadiness in walking. Once the side effects appear must immediately stop the drug. Botulinum toxin treatment: Botulinum toxin injection can reduce the electrical signal transmission of facial nerve, the first injection can control the symptoms for 3-6 months, the second injection can also be effective, multiple recurrences can even be treated by multiple injections; however, the later effect is getting worse and worse, repeated injections can lead to persistent facial paralysis. At present, acupuncture, massage and other Chinese medical treatments are considered to be ineffective! Microvascular decompression: Microvascular decompression is performed under a microscope or endoscope to relocate the blood vessels compressing the facial nerve in a minimally invasive way to treat facial muscle spasm from the etiology. At the same time, intraoperative electrophysiological monitoring means to guide the means, improve the cure rate and reduce the risk of surgery. The treatment effect is good and the recurrence rate is low.