Facial twitching, also known as facial muscle spasm, is a common functional disorder of the cranial nerves in middle-aged and elderly people. It manifests as paroxysmal involuntary twitching of half of the facial muscles, which mostly develops after middle age and is more common in women. The twitching of the corners of the mouth is most easily noticed, especially in social situations, when talking with people and being noticed, the attack is more powerful, giving people the feeling of squeezing their eyebrows, while the patient himself is suffering. The disease is a slowly progressive disease that does not get better naturally. If no treatment is given, the twitching stops in some cases at a late stage due to facial muscle paralysis. The former is mostly caused by tumor, inflammation and other factors, which accounts for a small proportion. This causes the facial muscles to twitch involuntarily, just like a short circuit and leakage caused by a broken outer skin of an electric wire. The incidence of this disease is very high, and there are many traditional treatments, such as oral sedative drugs, plasters, acupuncture, physiotherapy, closure, etc., but the effect is poor. Some closed treatment is effective, but it is at the expense of the patient’s facial nerve function, resulting in facial nerve damage, which can be seen in such patients with partial paralysis of the posterior muscles after treatment, and some are still twitching. Currently, there are two recognized effective methods: one is local injection of botulinum toxin A (BTX-A), which is a biological toxin injected into the corners of the eyes, mouth and other orbicularis muscle, resulting in weakened nerve-muscle junction nerve conduction, facial muscle stop twitching. The advantage of this method is that it is non-invasive, less costly and has fewer side effects; the disadvantage is that it is not long-lasting, relapses after 3-4 months and requires re-injection of botulinum toxin A. In some patients, it is not easy to grasp the amount of injection, and the facial paralysis is poor when the amount is large, and the effect is poor when the amount is small. Another method is microvascular decompression of the facial nerve root, which is a real treatment for the cause of the disease. The operation is done by making a small incision behind the patient’s ear on the sick side, drilling a small hole in the skull to enter the skull, and finding the blood vessel compressing the facial nerve at the root of the facial nerve, which is mostly a branch of the anterior inferior cerebellar artery or posterior inferior cerebellar artery. The procedure is completed by gently pushing it away from the facial nerve root and placing Teflon cotton wool between them to completely isolate it so that it no longer compresses the facial nerve root. The procedure takes about an hour and has an immediate effect, solving the problem once and for all, with an efficiency rate of 95-97% or more, a very low recurrence rate, and minimal side effects, making it the best treatment for this disease.