Facial muscle spasm, also known as facial muscle twitching, hemifacial spasm, except for a few secondary lesions such as tumors, aneurysms and arteriovenous malformations in the pontocerebellar horn area, generally refers to primary or idiopathic cases, manifesting as paroxysmal, rhythmic twitching, spasms or tonic seizures of one side of the facial muscles. The twitching mostly starts from the orbicularis oculi muscle on one side and gradually expands downward to the orbicularis oris muscle and facial expression muscle, causing facial pain in severe cases and affecting vision, speech and sleep. Clinical symptoms: 1. The spasm is intermittent at the beginning, but gradually becomes more frequent, and the symptoms can be aggravated by emotional stress and fatigue. 2. 4. Physical examination shows no positive neurological signs other than facial twitching symptoms; 5. Treatment: Microvascular decompression is the only treatment that can cure facial myoclonus. 1. Drugs: poor efficacy. Carbamazepine, phenytoinamide, baclofen and various sedative and tranquilizing drugs can reduce the symptoms for a few patients. 2, Chinese medicine: traditional Chinese medicine, acupuncture, etc. 3, botulinum toxin injection method: the treatment mechanism is to use botulinum toxin to block neuromuscular transmission and reduce the degree of facial muscle spasm without affecting the normal nerve conduction. It is reported that the early complete relief reaches 80%-100%, but generally 12-16 weeks, after the metabolism of botulinum toxin, the symptoms recur and the injection must be repeated. Common complications include facial paralysis, dry eyes, diplopia, and dysphagia. After 3 years of cumulative injection, the complications amount to 60%-75%. 4, ethanol injection method: injected with different concentrations of anhydrous ethanol in the facial nerve stem can temporarily interrupt the conduction function of the facial nerve, so that facial muscle paralysis or incomplete paralysis, such facial muscle paralysis in a few months can be recovered. This method has a short duration of efficacy, and is now used less frequently. 5.Surgery: mainly microvascular decompression, suitable for: ① primary facial muscle spasm, exclude secondary lesions; ② no history of facial nerve injury; ③ poor conservative treatment; ④ no serious systemic disorders. Other surgical methods, such as facial nerve commissurotomy or branch severing, are basically not used at present because they destroy the conduction function of facial nerve and replace twitching with paralysis.