Facial palsy and facial muscle spasm are both problems of the facial nerve, but they are completely different diseases and are treated in different ways. Facial palsy is also known as facial nerve palsy, commonly known as “crooked mouth”, “facial neuritis”, “crooked mouth wind”, etc. It is a common disease mainly characterized by motor dysfunction of facial expression muscles, specifically, it is manifested as crooked mouth and eyes. The clinical manifestation of facial palsy is very special. Most patients often suddenly find that one cheek does not move well and the mouth is crooked when they wash their faces or rinse their mouths in the early morning. Facial myoclonus is a paroxysmal involuntary twitching and jumping of the facial muscles, usually starting with involuntary jumping of the eyelids, then progressing to the corners of the mouth, and in severe cases, extending to the entire half of the face. If the symptoms persist for three months, the diagnosis of facial myoclonus is confirmed. Facial myospasm usually starts with a twitch of the eyelid orbicularis muscle, and then progresses to cause a twitch of the entire face as the patient’s condition progresses. Facial myospasm causes a lot of problems for patients, including physical and psychological effects. Facial muscle spasm is the twitching caused by the compression of the facial nerve by blood vessels, and as long as the blood vessels that compress the nerve are separated through surgery, the facial muscle spasm will be completely cured. Microvascular decompression surgery is a surgical procedure to separate and fix the blood vessels compressing the facial nerve, so that the facial twitching will disappear immediately. Microvascular decompression is the first choice for clinical treatment of facial muscle spasm, which has the characteristics of small trauma, high safety and cure rate, low complication rate, especially the complete preservation of blood vessel and nerve function, and has become the most effective treatment for facial muscle spasm at present.