Facial muscle spasm, commonly known as facial twitching, is a chronic disease characterized by involuntary, paroxysmal, painless twitching of the muscles innervated by one side of the facial nerve. The more nervous you are, the more severe the spasm. As the initial symptom of facial spasm is eyelid jumping, folklore also has the name “left eye jumping for money, right eye jumping for disaster”, so generally do not attract people’s attention, after a period of time the foci formed, developed into facial muscle spasm, linked to the corners of the mouth, serious even with the neck. The incidence of the disease is one in 100,000, mostly in middle-aged and elderly people, with a good prevalence in women, and a few cases can develop into mild facial paralysis at the end. The cause of facial muscle spasm is currently thought to be mainly due to “vascular compression”, that is, abnormal vascular compression of the facial nerve out of the brainstem area, resulting in a “short circuit” caused by nerve demyelination. Facial muscle twitches can be light at first, lasting only a few seconds, and then gradually lengthened to several minutes or longer, while the interval is gradually shortened and the twitches gradually increase in frequency, and in severe cases, they are tonic, causing the ipsilateral eye to be unable to open, the corner of the mouth to be skewed to the ipsilateral side, and the inability to speak, often aggravated by fatigue, nervousness, and voluntary movement, but cannot imitate or control their attacks by themselves, and most twitches stop after sleep. Frequent seizures make the patient feel distracted and unable to work or study, which seriously affects the patient’s physical and mental health. So what should we do if we have facial spasm? There are four common treatments for facial muscle spasm: ① medication: early patients can apply luminal, valium, carbamazepine and other medications, which can make some patients reduce facial twitching. However, the application of carbamazepine should pay attention to the occurrence of side effects such as white blood cell drop, drug hepatitis, exfoliative dermatitis. Closed treatment: one is nerve stem closure, often using quinine in the facial nerve at the extracranial stem closure, the use of quinine in the local toxic effect on the nerve stem on the anesthetic effect on the nerve to improve the face pumping, its effect can be up to several weeks. The second is botulinum toxin closure, botulinum toxin is a bacterially produced large molecule protein toxin, acting on the nerve endings, acting as an inhibitor, thus causing paralysis of the facial muscles to achieve the effect of stopping twitching. The method is to use botulinum toxin in the affected face multi-point injection, its efficacy can reach several months. Radiofrequency treatment: The application of controlled temperature-regulated radiofrequency instrument, the radiofrequency needle penetrated into the nerve hole behind the ear, with a certain temperature to produce damage to the nerve and achieve the purpose of relieving facial muscle spasm. The disadvantage of this method is that although the facial muscle spasm is relieved, a considerable number of patients have different degrees of facial palsy, and some of them have no improvement in facial palsy after a period of time while facial twitching can appear again. Microvascular decompression therapy: The root cause of facial muscle spasm is the compression of the facial nerve by blood vessels when it exits the brainstem. Therefore, microsurgical techniques are used to separate the compressed blood vessels from the nerve to treat facial muscle spasm, called microvascular decompression. The procedure requires only a small incision behind the ear and a hole the size of a copper coin in the skull. The compressed blood vessels are separated under a microscope and a special cotton pad is inserted, and the wound is sutured. The procedure is minimally invasive, efficacious, and safe from recurrence, and is currently the only method to cure facial spasm. Patients with facial myospasm should choose the treatment according to the clinical symptoms and the patient’s own condition. Patients with mild limited facial myospasm can be observed without treatment if they do not feel obvious pain and do not affect their work, study and social life. For patients with more severe symptoms, the best choice is microvascular decompression, which can remove the cause of the disease and is the only method to cure facial myospasm, while the surgery is minimally invasive, safe and effective, and not easy to recur, so that facial myospasm can be treated at all.