Facial muscle spasm, commonly known as facial twitching, is a chronic disease characterized by involuntary, true-onset, painless twitching of the muscles innervated by the facial nerve on one side. It occurs in middle age and above. The cause of facial muscle spasm is currently believed to be mainly due to “vascular compression”, i.e., the facial nerve is compressed by abnormal blood vessels in the brainstem area, resulting in a “short circuit” caused by the demyelination of the nerve. There are four common treatments: medication Early patients can be treated with luminal, valium, carbamazepine and other drugs, which can reduce facial twitching in some patients. However, the application of carbamazepine should pay attention to the occurrence of side effects such as white blood cell drop, drug hepatitis, exfoliative dermatitis. The first is nerve trunk closure, often using quinine in the facial nerve at the extracranial trunk closure, the use of quinine in the local toxic effect on the nerve trunk of the anesthetic effect on the nerve to improve the facial twitching, its effect can be up to several weeks. The second is botulinum toxin closure, botulinum toxin is a large protein toxin produced by bacteria, which acts on the nerve endings to inhibit the effect, thus causing paralysis of the facial muscles to achieve the effect of stopping twitching. The method is to use botulinum toxin in the affected face multi-point injection, its effect can be up to several months. Radiofrequency treatment The radiofrequency needle is inserted into the nerve foramen behind the ear with a controlled temperature-regulated radiofrequency instrument, and the nerve is damaged by a certain temperature to relieve facial muscle spasm. The disadvantage of this method is that although the facial muscle spasm is relieved, a considerable number of patients have different degrees of facial paralysis, and some of them have no improvement of facial paralysis after a period of time and facial twitching can appear again. Microvascular decompression The underlying cause of facial muscle spasm is the compression of the facial nerve by blood vessels as it exits the brainstem. Therefore, microsurgical techniques are used to separate the compressed blood vessels from the nerve to treat facial muscle spasm, called microvascular decompression. The procedure requires only a small incision behind the ear and a large copper hole in the skull. The compressed blood vessels are separated under the microscope and a special cotton pad is inserted and the wound is sutured. The procedure is minimally invasive, efficacious, safe and resistant to recurrence, and is currently the only method to cure facial spasm. Patients with facial myospasm should choose the treatment according to the clinical symptoms and the patient’s own condition. Patients with mild limited facial myospasm can be observed without treatment if they do not feel obvious pain and do not affect their work, study and social life. For those with more severe symptoms, medication can be applied at an early stage. When drug treatment is ineffective or relapses, facial spasm can be treated by one of the last three methods mentioned above if it has significantly affected life, work, study and social life. For those who are older (>70 years old) or have severe hypertension, coronary heart disease, diabetes, etc., closed or radiofrequency treatment is chosen. However, these methods are all symptomatic or symptomatic treatment, treating the symptoms but not the root cause. If the general condition allows, the best choice is microvascular decompression, which can remove the cause of the disease and is the only method to cure facial muscle spasm, while the surgery is minimally invasive, safe and effective, not easy to recur, so that facial muscle spasm can be treated fundamentally.