Any disease can only be effectively treated if it is accurately diagnosed, and facial spasm is no exception. Facial muscle spasm is also known as facial twitching, which mainly manifests as paroxysmal twitching of part or all of the facial expression muscles innervated by one side of the facial nerve. So, what is the differential diagnosis of facial spasm? The diagnosis is not difficult according to the clinical manifestations. However, it needs to be differentiated from the following diseases: 1. Hysterical blepharospasm, which occurs in middle-aged and elderly women, is bilateral, without lower facial muscle twitching. 2. Meige’s syndrome, or blepharospasm oromandibular dystonia syndrome. The diagnosis of paroxysmal facial muscle spasm is separate from other diseases. Meige syndrome also occurs in older women, manifesting as blepharospasm on both sides, and is accompanied by dystonia of the orofacial, facial, mandibular, laryngeal and cervical muscles. 3, habitual tics, mostly in children and young adults, are often more pronounced muscle contractions and are associated with psychiatric factors. 4, drug-induced facial muscle dyskinesia has a history of recent use of antipsychotic drugs such as Endrin, trifluoperazine, haloperidol or metoclopramide, manifested as forced mouth opening or closing, involuntary tongue extension or curling and other movements, and facial muscle spasm performance is different.