What is facial muscle spasm? Facial muscle spasm is also known as facial muscle twitching. It is a paroxysmal, rhythmic twitching, spasm or tonic seizure of one side of the facial muscles. The twitching mostly starts from the orbicularis oculi on one side and gradually expands downward to the orbicularis oris and facial expression muscles, causing facial pain in severe cases and affecting vision, speech and sleep. It is mostly on one side. The incidence rate is 64/100,000; the patients are mostly adults over 40 years old, male: female = 2:3. How does “facial myoclonus” occur? Facial myoclonus manifests as paroxysmal involuntary twitching of the facial muscles on one side of the face, and is more common in middle-aged women and older. The spasm often starts from one side of the eye or corner of the mouth, and then extends to the same side of the half of the facial muscles, showing intermittent involuntary rhythmic twitching, and cannot be controlled by oneself. Each twitch lasts from a few seconds to several minutes, with variable intervals. Frequent seizures can affect vision, speech or chewing function, and patients can hardly tolerate them. What are the causes of facial muscle spasm? (1) Vascular factors: It is known that more than 90% of patients have vascular compression of the facial nerve in the brainstem area. (2) Non-vascular factors: non-vascular occupying lesions in the pontocerebellar cerebellar angle (CPA), such as granulomas, tumors and cysts. (3) Other factors: such as demyelinating lesions of the facial nerve,, facial nerve injury, etc. What are the manifestations of “facial spasm”? 1. It mostly occurs after middle age, more in women than in men. 2. Early on, it starts from the orbicularis oculi muscle on one side, and gradually expands to other facial muscles on the same side. 3. The twitching is most obvious in the orbicularis muscle. 4. It occurs mostly on one side and is aggravated by mental tension and fatigue. What tests should be done for facial muscle spasm? CT and MRI examination of the head should be routinely performed. If necessary, x-ray of mastoid process and skull should be performed to exclude mastoid process and skull disorders. How to treat facial muscle spasm? 1.Drugs: the treatment is not effective. Carbamazepine, phenytoin, baclofen and various sedative and tranquilizing drugs can reduce symptoms in a few patients. 2, carnitine injection method: the treatment mechanism is the use of carnitine to block the neuromuscular transmission. It is reported that the early complete relief up to 80%-100%, but generally 12-16 weeks after the recurrence of symptoms, must repeat the injection. Postoperative complications amount to 60%-75%. 3, radiofrequency temperature-controlled thermal coagulation therapy: using the principle of electric coupling, the radiofrequency makes the nerve fibers generate heat between the temperature of 65-70 ℃, so that the nerve thermal coagulation denaturation, in order to reduce the nerve fibers that conduct abnormal impulses. It is easy to recur after the operation, and even permanent facial paralysis occurs. 4.Surgery: Microvascular decompression, which refers to the removal of the compression of blood vessels on the nerve under the operating microscope through the locking eye, to achieve the treatment purpose. Microscopic microvascular decompression is by far the most effective and safe method for treating facial spasm in the world, and the patient’s convulsions will stop after surgery, and the facial nerve function will be preserved intact. The director of neurosurgery department of our hospital has performed more than one hundred cases of facial myospasm, and the operation lasted only one hour, and the clinical symptoms disappeared immediately after the operation, with an overall efficiency of more than 96%. Surgical cost of facial spasm The general hospitalization time is 10 days, and the total cost is about 20,000 yuan.