Whether sudden involuntary facial twitching is normal or not cannot be generalized, and its causes include physiological and pathological reasons. Facial twitching is commonly caused by facial muscle spasm and focal seizures in epilepsy. Facial spasm is one of the common diseases in neurology, which can be divided into physiological and pathological. Physiological facial muscle spasm is mostly caused by overexertion, staying up late and mental tension, and is generally a transient twitch. After sufficient rest and relief of mental tension, the symptoms can be significantly reduced or disappeared without special treatment. Pathological facial muscle spasm is mostly caused by the compression of blood vessels and tumors in the intracranial segment of facial nerve, and patients with prolonged symptoms are recommended to have a cranial CT or cranial MRI examination to clarify the cause. Patients can take oral carbamazepine to relieve symptoms, or be treated by facial nerve vascular decompression or intracranial tumor resection. For sudden facial convulsions due to focal seizures, patients need to undergo EEG examination and antiepileptic treatment after confirmation of the diagnosis. Patients with facial twitching can massage the facial muscles appropriately, and also apply heat to improve local blood circulation, which will help the recovery of facial muscle spasm.