Facial muscle spasm, also known as facial muscle twitching, is a common and prevalent clinical condition. The disease usually occurs after middle age, and is initially manifested as paroxysmal twitching of one eyelid, which can gradually extend to upper and lower eyelids and half of the facial muscles, resulting in crookedness of the mouth and difficulty in opening the eyes, seriously affecting the patient’s normal life and work. Although the treatment of facial muscle spasm is very mature, not many patients can really get timely and reasonable treatment. Common misunderstanding 1: unclear understanding. Many patients in the clinic still do not know that they are suffering from facial myospasm even at the advanced stage of the disease, and they do not know that facial myospasm can still be cured. In fact, based on the typical symptoms of facial spasm patients can judge for themselves. The characteristic manifestation of facial muscle spasm is: paroxysmal involuntary twitching starting with one eyelid, which can be extended to other facial muscles on the same side with time, accompanied by twitching of the corners of the mouth muscles is most common, twitching repeatedly, which cannot be controlled by oneself, mostly aggravated when nervous and talking with others, which in severe cases leads to the inability to open the eyes and skewed corners of the mouth, and the patient feels distracted and unable to work or study normally. Of course, facial muscle spasm also needs to be distinguished from post-facial paralysis (a history of facial paralysis before the facial muscle twitches, and muscle twitches occur due to incomplete recovery from facial paralysis, mostly accompanied by varying degrees of facial muscle weakness), idiopathic blepharospasm (bilateral eyelid spasms at the same time, often accompanied by mental disorders), habitual facial muscle spasm (mostly starting in childhood, with the main manifestation of purposeless stereotyped or repeated jumping of facial muscles), and tardive dyskinesia and chorea. The difference between these two conditions is that they can be distinguished from each other. Common misconception 2: Misbelief in recipes. In order to treat facial muscle spasm, many patients listen to and believe in secret prescriptions, which not only wastes a lot of time and money, but also loses the best time for treatment, and in some cases, leaves serious sequelae. There was a patient of Guizhou origin with facial spasm, at the beginning of the disease, a local fortune-teller said that the patient was possessed by the ghost of a neighbor who had passed away many years ago, and asked him to spend money on practices at home, otherwise there would be an ominous disaster, but after working for a while, the patient’s symptoms not only did not reduce, but became more and more aggravated. Later, he heard that there are treatment prescriptions in Shanxi, and went to seek treatment, in the face and needles, and medicine, but the symptoms are not improved, desperate almost gave up the confidence to seek treatment. It was only in 2006 that he was introduced to Shanghai by a local neighbor who was working there and underwent microvascular decompression surgery, which completely cured the stubborn disease that had plagued him for years. In fact, what he was suffering from was the most common facial spasm. Common misconception 3: Improper choice of treatment plan. The current clinical treatment methods for facial muscle spasm include medication, acupuncture, Chinese herbal medicine, botulinum toxin injection, closure, microvascular decompression, etc. Different methods have different efficacy and indications. For example, although oral carbamazepine or Dexedrine can temporarily reduce the degree of twitching, it cannot cure the twitching, and these drugs have certain side effects, so drug therapy is only suitable for patients in the early stage of the disease or in poor general condition who cannot receive other treatments. Botox injection, for example, blocks nerve conduction through the toxic effect of the drug on the nerve. Its advantage is that it is simple to operate, but its biggest disadvantage is that facial paralysis of different degrees will occur after treatment, and the symptoms will reappear after recovery from facial paralysis, so repeated injections are needed. Microvascular decompression is currently the only treatment method that targets the cause of the disease. Its disadvantage is that it requires surgical treatment, but its biggest advantage is that it can cure the facial muscle spasm and may preserve the normal function of the facial nerve, so microvascular decompression has become the preferred treatment option now. Common misconception 4: Overly worried about the risk of surgery. In fact, no one would be willing to undergo surgery as a last resort. But what should be advocated is to fully understand the principles of facial muscle spasm and the pros and cons of various treatment methods before choosing a treatment option that suits you. Secondary facial muscle spasm refers to the facial muscle twitching caused by intracranial diseases such as cholesteatoma, auditory neuroma, meningioma, cerebrovascular malformation, etc. Of course, treatment of the primary disease should be the main choice. The primary facial muscle spasm is the result of nerve demyelination due to intracranial vascular compression of the facial nerve, which has been confirmed by MRI and pathological examination, so only by displacing the compressed vessels can facial nerve decompression be achieved. In fact, microvascular decompression itself is a minimally invasive surgical technique that has been widely carried out in major medical centers, and the standardization, safety and effectiveness of the procedure have been developed to a fairly mature level. It turns out that facial myospasm is a common disease that can be cured. We hope that patients suffering from facial myospasm will seek early medical treatment, get effective treatment and recover their health as soon as possible.