Facial muscle spasm (HFS) is a recurrent paroxysmal, involuntary twitching of one or both facial muscles (orbicularis oculi, expression muscles, orbicularis oris), aggravated by emotion or tension, and in severe cases, difficulty in opening the eyes, distorted corners of the mouth, and twitching-like murmurs in the ears. It is more common in middle-aged and elderly people, with slightly more women than men, and the age of onset is trending younger. Although facial myoclonus is mostly located on one side, bilateral facial myoclonus is not uncommon. The diagnosis mainly depends on the characteristic clinical manifestations, and the related auxiliary examinations include: electrophysiological examination, imaging examination, and carbamazepine treatment test. 1, Electrophysiological examination includes electromyography (EMG) and abnormal muscle response (AMR) or called lateral spread response (LSR) test. 2, Imaging tests include CT and MRI to identify intracranial lesions that may be causing facial myoclonus. 3. Patients with facial myasthenia are generally effective on carbamazepine treatment at the beginning of the disease (a small number of patients may appear ineffective). Bilateral blepharospasm: This is characterized by recurrent episodes of involuntary eye closure of both eyelids, often with simultaneous onset of bilateral eyelids. 2, Meijer syndrome: Patients often start with recurrent episodes of involuntary eye closure of the eyelids bilaterally, but with the prolongation of the disease, there will gradually be involuntary twitching of the muscles below the eye fissures, manifesting as involuntary abnormal movements of the face bilaterally, and as the disease worsens, the scope of muscle spasm will gradually expand downward, even involving the muscles of the neck, extremities and trunk. 3, occlusal muscle spasm: spasm of unilateral or bilateral masticatory muscles, patients may have different degrees of upper and lower jaw occlusion disorder, teeth grinding and mouth opening difficulties, trigeminal nerve motor branch lesion is one of the possible causes. 4. Facial palsy sequelae: manifested as restricted movement of ipsilateral facial expression muscles, involuntary twitching of the ipsilateral corners of the mouth and conjoined movement of the corners of the mouth and eyelids, which can be identified based on the exact history of facial palsy. Treatment 1.Medication: Commonly used drugs include carbamazepine, oxcarbazepine and Valium, etc. Alternative drugs are phenytoin sodium, clonidine, baclofen, topiramate, gabapentin and haloperidol, etc. 2.Botulinum toxin injection: commonly used drugs for injectable botulinum toxin type A. 3, microvascular decompression: indications include: the diagnosis of primary facial muscle spasm is clear, secondary lesions are excluded by cranial CT or MRI; facial muscle spasm symptoms are serious, affecting daily life and work, and patients are strongly willing to operate; patients treated with drugs or botulinum toxin should be actively operated if there is poor efficacy, ineffectiveness, drug allergy or toxic side effects; patients with recurrence after MVD surgery can be operated again; Patients with ineffective post-operative MVD can be considered for early reoperation if the first surgical decompression is considered inadequate and the post-operative AMR test is positive. Complications Common complications include: cerebral neurological dysfunction, cerebellar and brainstem injury, cerebrospinal fluid leakage, low intracranial pressure syndrome, other complications, etc.