Facial muscle twitch is also called facial muscle spasm, and its common clinical manifestation is that most patients with primary facial muscle twitch start after middle age, and there are more females. The main manifestation is paroxysmal contraction, starting from small twitches of orbicularis oculi, and gradually extending to the lower expression muscles, including the upper lip square, laughing muscle, lower lip square and deltoid muscle twitches, starting from small local twitches at the corners of the mouth, and gradually expanding to large expression muscle twitches. When the twitching of orbicularis oculi muscle is serious, it may affect the blurred vision. The twitching is more severe when nervousness and emotion are present. Facial muscle twitching can also occur during the recovery period of facial palsy. The cause of facial twitching is not known and may be caused by ectopic excitation of the facial nerve or pseudo-synaptic transmission. It has been reported both in China and abroad, and surgical and autopsy material has confirmed that facial twitching is due to some kind of compression that causes pathological disturbance in the conduction of the facial nerve. The vast majority of patients are due to cross-compression of normal vessels, such as compression of the posterior inferior cerebellar artery, anterior inferior cerebellar artery, and vertebral artery. Occasionally, this is due to compression of the facial nerve root by aneurysms, arteriovenous malformations, or brain tumors. Very few patients present with twitching of the affected facial muscles after trauma, tumor or surgery. Treatment includes sedative medication, botulinum toxin therapy, block therapy and surgery, all with varying degrees of recurrence. The best results are obtained by decompression of the posterior cranial fossa with microvascular decompression to relieve the compression of the facial nerve by the anterior inferior cerebellar artery or other vessels.