From time to time, patients come to the clinic and ask what to do if their eyelids are throbbing. Do I need surgery? A look of anxiety. The patient insisted that there was and asked me to take a closer look. I looked closer and saw that there was indeed a very slight eyelid flutter, so I couldn’t help but laugh. In fact, eyelid fluttering like this, or blepharospasm, is usually physiological. It is caused by repeated contractions of the orbicularis oculi muscle due to factors such as fatigue, anxiety, and poor rest. It can be relieved on its own after taking care of rest and does not require treatment. In contrast, true facial spasms, although more pronounced during episodes of stress and anxiety, generally cannot be completely relieved by rest. More importantly, physiological blepharospasm is usually mild, and although it is obvious to oneself, it is difficult to detect bystanders without careful observation; whereas facial myospasm can lead to a significant reduction in the eye fissure, commonly known as a smaller eye, and after a period of time, it can also involve the corners of the mouth, causing the corners of the mouth on the same side to appear skewed to one side. This is the more obvious difference. In addition, through a large number of clinical observations, a significant number of patients with facial myoclonus also have a developmental deformity of a sunken skull base and a narrow posterior cranial fossa, manifested by a short neck and a low posterior hairline. Of course, it is not necessary to have facial myoclonus to have a narrow volume of the posterior cranial fossa, and please don’t put your friends with short necks in the right place.