Symptomatology Abnormal twitching of facial muscles that is difficult to control, most of the muscle twitching is limited to one side, often occurring first in the lower eyelid, similar to “eyelid jumping”, gradually spreading from the top down to the corners of the mouth, upper and lower lips, cheeks, and extending to the hemifacial muscles, and in severe cases, the neck muscles on the same side also appear twitching. If observed carefully, a single bundle of muscles or multiple bundles of muscles can be seen to contract rapidly and frequently. This involuntary spasm cannot be controlled by oneself. Chewing, transient eyes or random expression movements can cause facial muscle twitching episodes, which can be triggered or aggravated by factors such as emotional excitement or prolonged reading time. The performance of the eyelids are tightly closed, the corners of the mouth are skewed, and generally each seizure lasts from a few seconds to a few minutes, with intervals of variable length all as normal. In addition, some patients may also have tinnitus on the affected side and hearing loss. In addition, some patients may have tinnitus and hearing loss on the affected side. The disease can be classified into primary and secondary according to the cause. Secondary trigeminal neuralgia refers to patients with clinical symptoms and significant organic and/or functional lesions, while primary trigeminal neuralgia refers to patients with no relevant lesions on various tests. The diagnosis of the disease is mainly based on the typical clinical manifestations. The differential diagnosis is also based on neurological examination and related imaging. EEG and EMG should be performed routinely, and if necessary, mastoid, cranial X-ray, cranial CT and MRI should be performed to exclude mastoid and cranial disorders. In recent years, some special MRI-related examinations such as MRTA and stereoscopic imaging techniques can provide images of vascular-neural relationships, but still rely on what is seen intraoperatively to confirm the diagnosis. Differential diagnosis 1. Secondary facial myoclonus. Tumors or inflammation of the pontocerebellar horn, pontocerebellar tumors, brainstem encephalitis, medullary cavitation, motor neuron disease, and craniocerebral injury can present with facial myoclonus, but are often accompanied by other manifestations of cranial nerve or long tract damage. For example, ipsilateral facial pain and facial hyperalgesia, hearing impairment, contralateral or extremity muscle weakness, etc. Facial myospasm is only one of its symptoms and is not difficult to identify. 2. Hysterical blepharospasm. It is common in middle-aged female patients, mostly bilateral, and is only limited to the spasm of the eyelid muscle, while the facial muscle of the lower part of the face is not involved. 3. Habitual facial muscle twitching. It is common in children and young adults, and is a brief forced facial muscle movement, often bilateral. The EMG and EEG of hysterical blepharospasm and habitual facial muscle twitches are normal, and the muscle contraction waves appearing on the EMG during twitching are the same as those produced during active movement. 4, trigeminal neuralgia is a paroxysmal transient severe pain in the face, which can be accompanied by facial muscle twitching when the pain is severe. Although primary facial muscle twitches can also cause facial pain when they develop into severe, the pain is not as severe as trigeminal neuralgia, so it is not difficult to distinguish. 5, chorea and tardive dyskinesia. There can be involuntary twitching of facial muscles, but both are bilateral, and both are accompanied by similar involuntary movements of the limbs, which can be distinguished.