How to distinguish between “facial spasm” and “eyelid flutter”?

  Almost all facial spasms start with eyelid jumping, and simple eyelid jumping (medically called blepharospasm) is extremely common in daily life, and almost everyone has experienced it in their lifetime.  In folklore, there are some superstitious legends about eyelid jumping, such as “left eye jumping for money, right eye jumping for disaster”. Simple eyelid jumping is caused by focal excitation of the nerve muscles that govern eyelid movement, and this condition mostly resolves on its own after a period of time. In the case of facial spasms, the eyelid spasms do not stop on their own, but get heavier and heavier, gradually involving the facial muscles and even the neck and shoulder muscles after a period of jumping.  Therefore, it is important not to rush to seek medical attention after the onset of blepharospasm, because simple blepharospasm does not develop into facial muscle spasm. In the case of facial muscle spasm, general treatment cannot stop the natural course of the disease in which the facial muscle twitching gradually worsens.  Meige syndrome is a limited dystonia disorder. The main manifestations are bilateral eyelid spasms, facial dystonia-like involuntary movements, and are common in middle-aged and elderly women, with bilateral eyelid spasms as the first symptom, and ptosis and lid weakness are also common. Some patients have spasmodic attacks of the neck and trunk muscles or dance-like movements of the upper limbs, and spasmodic dysphonia and dyspnea when the laryngeal and respiratory muscles are invaded.  In addition, facial muscle spasm should be differentiated from hysterical blepharospasm, habitual facial twitching, and restrictive epilepsy.