Facial muscle spasm, also known as facial muscle twitching, manifests as involuntary paroxysmal twitching of facial muscles at one time, with different degrees, and can be aggravated by fatigue, mental tension and voluntary movement. The onset of the disease mostly starts from the orbicularis oculi muscle, and then involves the whole face. Frequent attacks can affect normal work and life, and even physical and mental health. The most direct and effective treatment is facial nerve microvascular decompression, the principle of which is consistent with the pathogenesis of facial myospasm. However, because the treatment is open-heart surgery, many patients choose local botulinum toxin injection for fear of the risk of open-heart surgery. With the application of high magnification microscopes and the development of surgical instruments, as well as the rich clinical experience of the surgeon, the procedure is very safe. In contrast, botulinum toxin injection treatment is an invasive treatment, which can lead to local expression muscle closure, resulting in local facial deformation, causing local “mask feeling”, long time due to disuse atrophy resulting in facial muscle atrophy, which leads to left and right face asymmetry, and even facial paralysis, and the probability of recurrence of facial muscle spasm is very high.