Eyelid fluttering is often not a concern for many people. Indeed, occasional eyelid fluttering may be caused by fatigue of the eye muscles due to strain or overuse of the eyes, and most of them do not require treatment and can heal on their own within a week. However, it should be noted that if one side of the eyelid fluttering or facial muscles involuntary, repeated episodes of twitching for more than a month, then it is possible to suffer from facial myoclonus. Most patients start with eyelid fluttering, which slowly spreads to twitching of the cheek muscles after a few months, and the symptoms worsen when fatigued and emotionally excited, and are relieved after rest and disappear after sleep. This is because the blood vessels in the human brain flex, elongate, and harden with age. The facial nerve is a nerve fiber that innervates the eyelids and facial muscles, just like a thick wire, and due to the pressure of the blood vessels, the outer skin of the wire wears off and the inner wire filaments are exposed, resulting in a short circuit of the wire and sparks, thus inducing involuntary twitching of the eyelids and cheek muscles. Facial muscle spasms cause great psychological distress to patients, affecting basic social interaction, work, and depression, which is very painful for patients. I have learned in my clinic on Monday and Wednesday mornings that some patients even rush to the doctor and blindly choose medical treatments that do not cure the problem. In fact, in order to completely cure facial spasm, the compression of the facial nerve by the associated blood vessels must be removed from the etiology. At present, the use of microvascular decompression surgery (minimally invasive) to treat facial muscle spasm is one of the effective methods. Under a microscope, the surgery removes the responsible blood vessel that is compressing the nerve, and then wraps the damaged nerve with a medical spacer, isolating the contact between the nerve and the blood vessel, and the patient’s facial muscle spasm symptoms disappear immediately after the surgery. The surgery is short, with little damage to the patient’s nerves and blood vessels and few postoperative complications. In addition, patients are reminded of the need to differentiate facial spasm from other diseases of the facial nerve. In middle-aged and elderly patients with bilateral blepharospasm and Meijer syndrome, the eyes are difficult to open during the attack, the muscles around the orbits are tense, and in severe cases, the eyes cannot be opened at all. Facial nerve microvascular decompression surgery plus facial nerve combing can be effective in these patients. The clinical characteristics of muscle spasm behind facial palsy, the patient shows sudden onset of facial palsy on one side, with crooked lips, salivation, difficulty in closing eyelids, and even complications such as tinnitus, deafness, vertigo, etc. The symptoms mostly disappear in about a month, and after several months or years the patient feels stiffness and pulling sensation in the muscles of the affected side of the face. Microvascular decompression plus facial nerve combing surgery can also be helpful in the treatment of this group of patients.