In facial neurological disorders mainly include facial muscle spasm and facial paralysis. Some patients may confuse these two diseases due to lack of understanding. To summarize, facial muscle spasm is “moving wildly” and facial paralysis is “not being able to move”. The following is a detailed explanation of the difference between the two – Definition of Hemifacial Spasm Hemifacial spasm (HFS) is characterized by paroxysmal involuntary twitching of the facial muscles on one side of the face. The majority of facial twitches are unilateral symptoms, with very few (less than 1%) being bilateral sequential episodes. Definition of Facial Palsy Facial palsy (idiopathic facial palsy, Bellpalsy, BP), also known as Bell’s facial palsy or Bell’s palsy, is a simple peripheral facial nerve palsy without other features or symptoms for which no cause can be identified. Idiopathic facial paralysis has a unilateral onset, with isolated bilateral occurrences. Clinical manifestations of facial palsy are different 1. Onset: Most of the patients are over 40 years old, but there are still a few young patients. 2. 2. Characteristics of twitching: The onset of twitching starts from the upper and lower eyelids, and gradually and slowly expands to the cheeks to all the muscles of one side of the face, and the neck muscles can be involved in severe cases. 3. Duration of convulsions: The convulsions occur in paroxysms, and the intervals are gradually shortened with the aggravation of symptoms. The patient cannot control the convulsions by himself, and the seizures are often obvious when he is nervous, tired, meets strangers, or shows his face in public places. The convulsions usually stop after going to sleep, but there are cases in which the patient wakes up after going to sleep because of the convulsions. Clinical manifestations of facial paralysis 1, onset: mostly seen in young and middle-aged patients. Characteristics of facial paralysis: All facial muscles on the affected side are paralyzed, and the eyelids cannot be closed sufficiently. When shutting up, the cheek muscles are relaxed and the corner of the mouth droops. When raising the eyebrows, the frontal stripe disappears, the eyebrows are lower than the healthy side, the eyelid fissure is large, the inner corner of the eye is not sharp, and the tears spill out. The corners of the mouth are pulled toward the healthy side when smiling. Due to the paralysis of buccal muscles, food is stored between the buccal part and the gums when chewing. 3, other accompanying symptoms: ① Bell’s sign: the paralyzed side of the eyeball when the eyes are closed, the cornea below the sclera; ② eyeball sign: the affected side of the eyeball upward; ③ cervical vastus sign: the patient exerted forward flexion, the examiner against the forehead, the healthy side of the contraction of cervical vastus muscle, the affected side does not move; ④ auditory allergy: due to stapedius muscle paralysis, the tympanic tensor muscle tense, small sounds produce strong vibration, producing overhearing; ⑤ lacrimal gland secretion disorders: affected side of the reduced; ⑥ Salivary partition disorder: decreased secretion from the mandibular gland on the affected side. Treatment of facial muscle spasm 1, drug treatment: ① antiepileptic drugs: carbamazepine, oxcarbazepine and phenytoin sodium, etc.; ② B vitamins: methylcobalamin and glutamine. They can only relieve the symptoms of convulsions, but cannot completely control the symptoms. As the condition continues to aggravate, the dose of oral medication increases, and complications such as dizziness and disorientation occur. 2.Acupuncture or botulinum toxin: The maintenance time is about three months, usually not more than six months. Severe cases can cause facial paralysis. 3.Microvascular decompression surgery (MVD) for facial muscle spasms: the surgery to treat the disease by removing the blood vessels located in the root of cerebral nerves that have an abnormal course and cause compression through microscopic technology to relieve the compression of the blood vessels. It is the only treatment that can cure the disease by targeting the cause of the disease. Treatment of facial paralysis 1, hormone therapy: early and full dosage of hormone therapy, prednisone can be used for 7 days and then reduce the dosage day by day. 2.Antiviral therapy: according to patient assessment, new onset patients with severe symptoms and poor prognosis should be treated with antiviral and hormone therapy within 72 hours. Commonly used antiviral drugs include acyclovir or valacyclovir for 7 days.