Facial myoclonus, also known as facial twitching and hemifacial spasm, manifests as episodic, rhythmic involuntary twitching of one side of the facial muscles. The incidence of the disease is 1 per 100,000, mostly in the middle-aged and elderly population. In terms of the pathogenesis, the “short-circuit theory” is now recognized by clinicians, based on the fact that the facial nerve in the intracranial segment of the brainstem (REZ area) is compressed by the abnormal vascularity of the vertebrobasilar system, and the facial nerve is pathologically stimulated to produce abnormal neurophysiological impulses, resulting in facial muscle twitching. Guo Hongchuan, Department of Neurosurgery, Xuanwu Hospital, Capital Medical University In terms of clinical symptoms, the spasms mostly start from the lower eyelid on one side and gradually spread to the facial and even neck muscles. The spasms are intermittent at the beginning and gradually become more frequent, especially when the twitching of the facial muscles is obvious before emotional tension, fatigue and other triggers. In severe cases, the twitches can cause facial pain and affect vision, speech and sleep. Since the cause of facial muscle spasm is the compression of the facial nerve at the root of the REZ by abnormal vascularity, and the anatomical structure and function of the facial nerve and vascularity are normal, there are no other abnormal findings in physical examination except for paroxysmal involuntary twitching of the facial muscles on one side. In terms of special examination, MRI scan of the skull with 3D-TOF showed abnormal arterial vessels in the root of the facial nerve in the intracranial segment of some patients, but no other abnormal findings were found. The former includes oral medication and drug injection facial nerve block treatment. There is no special oral medication, but some sedative and tranquilizing drugs are commonly used in clinical practice; nerve block treatment is to block the conduction function of facial nerve by using botulinum toxin and ethanol, so that facial muscle spasm can be released. After the injection, the nerve conduction is impaired and the face is immediately paralyzed or incompletely paralyzed, and such facial muscle paralysis can be recovered within a few months. However, the effect is short-lived, and most patients relapse in about 3-6 months, requiring re-injection. Common complications include facial palsy, dry eyes, diplopia, and dysphagia. Other surgical methods are rarely used nowadays due to poor treatment effect and high surgical complications. Microvascular decompression was pioneered by an American neurosurgeon in the late 1960s. The procedure is performed by pushing away the blood vessel located at the root of the facial nerve (REZ) that is abnormal and causing compression to the facial nerve under the operating microscope, so that the blood vessel is permanently out of contact with the facial nerve, thus completely relieving the compression of the facial nerve root and restoring the normal function of the facial nerve, so that the facial muscle The twitching symptoms are relieved. With the perfection of this surgical technique, especially its minimally invasive, safety, remarkable effect, low recurrence rate and few complications, especially the ability to completely preserve the function of blood vessels and nerves, it was soon accepted by neurosurgeons all over the world and was promoted worldwide as the most effective method for treating facial muscle spasm. This minimally invasive procedure is performed under general anesthesia and is painless for the patient. The surgical incision is made in the hairline behind the affected ear, about 4-5 cm long, and a small hole of 2.5 cm in diameter is drilled in the skull. The whole surgical operation is done under a microscope to ensure the delicacy and safety of the operation, which takes about half an hour. Xuanwu Hospital of Capital Medical University introduced this technology in the 1980s and took the lead in research and clinical treatment of facial muscle spasm in China, and has treated thousands of patients and achieved satisfactory treatment results. Our treatment experience proves that the experience of the operator and the correct judgment and precise operation during the operation play a crucial role in the outcome of the operation. The minimally invasive technique of microvascular decompression for facial spasm has become one of the specialties of Xuanwu Hospital Skull Base Surgery Center. For more information, please call 15901233008 (if you cannot answer the phone, you must be in surgery, so please call in the evening or the next day).