Facial spasm is a chronic disease characterized by involuntary, paroxysmal, painless twitching of the muscles innervated by the facial nerve on one side, without other positive neurological signs. Electromyography shows myofiber tremor and myofascicular tremor waves. Facial muscle spasms tend to occur on one side and are rare in bilateral cases. It is generally believed to be more common in women than in men and to occur after middle age. Our statistics show that 60% of the patients are female and 80% of them are over 40 years old. 1, drug treatment Available sedative, tranquilizer, anti-epileptic drugs, such as luminal, valium, carbamazepine, etc., effective in some cases, especially in the early onset of cases. However, attention must be paid to its many drug side effects, such as drowsiness, mental depression, decreased granulocytes, drug-related hepatitis, exfoliative dermatitis, etc. There is a report in the literature that the “triad” of granulocyte drop, drug-related hepatitis and exfoliative dermatitis occurred after taking carbamazepine for 7 days for the treatment of facial muscle spasm. The “triad” such as untimely treatment can lead to the death of the patient. 2.Closure The nerve trunk is mostly closed with compound quinine, and the facial nerve trunk is punctured through the anterior border of the mastoid process, the posterior border of the mastoid process, and the parotid access method, and compound quinine 0.3-0.5ml is injected. Quinine injection is used because of its long-acting anesthetic effect. The effect of quinine is the result of the toxic effect of alkaloids on protoplasm, so the effect of quinine is proportional to its toxicity to cells, its anesthetic effect is long-lasting, and it takes several weeks for the nerve function to fully recover. Animal tests have also shown that it is safe to inject compound quinine into or around the femoral nerve of rabbits, with no permanent lesions and no adverse complications. 3.Triplex injection therapy The triplex injection therapy for facial muscle spasm is a special treatment for facial muscle spasm that we have gradually developed in clinical practice based on the study of a large amount of domestic and foreign literature on the treatment of facial muscle spasm. The main method is to selectively, purposely and individually inject the relevant drugs into the stem mammary foramen, the midpoint of the front folds of the ear screen and the relevant movement points of the face or the “sensitive points” detected by using special technology according to the specific situation of facial muscle spasm, so as to effectively relieve facial muscle spasm. Botulinum toxin injection therapy Botulinum toxin is a large molecule protein toxin produced by the anaerobic Clostridium botulinum, which mainly acts on motor nerve endings and inhibits the release of presynaptic membrane acetylcholine, thus causing muscle paralysis. The duration of action can be up to several months. Foreign reports indicate that 70% to 90% of people have significant efficacy. The duration of maintenance is positively correlated with the degree of symptom relief, the degree of concomitant lid ptosis and nasolabial fold superficiality, in other words, the maintenance of efficacy is dose-dependent and negatively correlated with the duration of the disease and the severity of the spasm. However, botulinum toxin is one of the most toxic bacterial toxins, and the appropriate dose and interval between repeated injections should be strictly controlled to avoid serious complications. 5.Facial nerve trunk commissurotomy In the general nerve trunk dissection method under conventional local anesthesia, about 1 cm of the general trunk is freed, and under a 5x surgical microscope, the facial nerve trunk is pulled up with an oral probe, then the outer membrane of the facial nerve trunk is peeled off with a microscopic sickle knife and inserted through the facial nerve trunk for fasciculation, because the facial nerve fibers are arranged in parallel, it is very easy to fasciculate, and it is routinely divided into 7-8 fasciculations, and more than 10 fasciculations in cases with severe symptoms. Some authors counted 74 cases of facial spasm treated with this method for more than 1 year, and the effective rate was 97.3%, with a recurrence rate of 2.7%. However, this method has the possibility of wound infection and affects the aesthetics. It also leaves the patient with varying degrees of facial paralysis, which often takes about 3 months to return to normal. It is difficult to operate again. 6. Microvascular decompression of the facial nerve root Since Schultze discovered the compression of the pontocerebellar angle by an aneurysm in the dissection of facial spasm cases in 1875, more and more scholars believe that facial spasm is caused by the slight and continuous compression of the facial nerve by blood vessels in the region of the exiting brain stem. In view of this, the purpose of relieving facial muscle spasm can be achieved by isolating the blood vessels and arachnoid membrane that are compressing the nerve in order to release the compression and short-circuiting of the facial nerve. In clinical practice, a 4cm – 6cm long transverse incision behind the ear under local anesthesia, a 2cm × 3cm cranial window, a “+” incision of the dura mater, a microscopic exploration of the pontocerebellar angle, the vessels within 2mm from the facial nerve root as the compressing vessels, i.e., the vessels responsible for facial spasm, and careful separation of the surrounding thickened and adherent arachnoid membrane. The arterial vessels were stripped from the nerve roots, and the facial nerve was padded with polytetrafluoroethylene cotton sheets between the arterial vessels and the nerve after different degrees of combing and stimulation were taken. Some authors counted 229 cases of facial spasm treated with this method for more than 6 months, of which 224 cases were effective, 2 cases were ineffective, and 31 cases were recurrent. The method has cerebrospinal fluid ear leakage, subcutaneous fluid accumulation, and ipsilateral hearing loss. With the improvement of surgical techniques and significant reduction of side effects, microvascular decompression of the facial nerve root is gradually becoming the mainstream method for effective treatment of facial myospasm.