Some patients suspect facial spasm and go to the clinic to see the doctor, only to have the doctor ask about the condition, let himself do a few grimacing movements, and then say it is facial spasm, let the observation for a period of time, is this not too hasty? The actual fact is that you can find a lot of people who are not able to get a good deal on this. In fact, to diagnose facial muscle spasm, it is important to ask questions and make expressions. Usually, the doctor will ask the patient to make movements such as opening and closing the eyes quickly, showing teeth and puffing incessantly, which are actually checking the function of the 5 branches of the facial nerve. If the patient cannot do these movements well, it means that there is a problem with the corresponding facial nerve function. The doctor then combined with the patient’s story and symptoms, he or she can roughly deduce whether it is facial muscle spasm. However, since 94% of facial spasms start with eyelid fluttering, how can we know if it is a real facial spasm or just eyelid fluttering? Time is the best test. Therefore, in general, the doctor will tell the patient to come back for a review in three months to see if the twitching has expanded to the corners of the mouth and neck; if the condition progresses quickly within three months, don’t wait three months, the patient should see the doctor again as soon as possible. But after all, it is hard to wait for three months, is there any way to confirm the diagnosis immediately? For example, a film, a blood test or something. In fact, CT can only reveal the structure of the skull and brain, and cannot see the tiny blood vessels and nerves. The doctor suggested some patients to do CT to clarify whether the facial muscle spasm is caused by cranial tumor, but CT is not very meaningful for confirming whether it is facial muscle spasm. The ordinary MRI can only see the structure of nerves and brain tissues, and it is unlikely that the tiny blood vessels can be detected, so it is still impossible to tell whether the blood vessels are pressing on the facial nerve, and the diagnosis is not significant. The special MRI (3D-TOF-MRA) is not for diagnosis, but to clarify the relationship between the “blood vessel in question” and the facial nerve, and to better guide the surgery. If surgery is not planned, this special MRI is not necessary. Finally, blood biochemical tests are only done to see if the blood lipids are high and if there is atherosclerosis, and it is unlikely to directly diagnose facial spasm. Therefore, for this neurological functional disease, it is best to observe for a period of time to see how the disease progresses before making a judgment, after all, facial myospasm is not a critical disease and waiting for three months usually does not have serious consequences. If the patient’s symptoms are already heavy, a special MRI can be considered for the next treatment. This special MRI film is valid for one year, but if it is more than one year, it will need to be redone because the disease will have progressed somewhat, and the cost is usually about $1000. If the MRI is done on the same day as the outpatient visit, the results will be available the next day.