Facial myoclonus is a peripheral facial nerve disorder. The common cause is compression of the facial nerve root by heterogeneous vascular loops at the facial nerve outlet, and in a few cases, it may also be due to compression by lesions such as tumors, granulomas, and vascular malformations in the pontocerebellar horn region. Usually, there are three main types of effective clinical treatments for facial spasm: oral medication, microvascular decompression surgery, and local botulinum toxin injection. For patients with mild symptoms at the beginning of the disease, oral medication can be tried, but oral medication is often ineffective for patients with long duration of disease and severe symptoms. Treatment of lateral facial myasthenia with botulinum toxin type A is the main treatment for facial myasthenia in China in the last 20 years. Different literature reports that this therapy can result in significant improvement or complete relief of symptoms in 76% to 100% of patients, with an average duration of efficacy of 2.6 to 6 months. Its advantages of safety, efficacy, simplicity, fast onset of single treatment and long duration of efficacy have made it widely used in clinical practice. However, this therapy is only symptomatic treatment, not etiological treatment. Generally, the effect starts 3-5 days after botulinum toxin injection and reaches its peak in 1~2 weeks. The appearance of eyelid edema and facial edema for a period of time after botulinum toxin injection therapy may be related to the elimination of spasm and changes in local fluid dynamics. Eyelid and facial edema due to tissue fluid accumulation usually resolves on its own within 1 to 2 weeks; local massage is slightly helpful in improving edema. The side effects of using botulinum toxin to treat facial myasthenia include mainly reactions related to weakness of the target muscles and local reactions to the injection. They are generally self-limiting and usually recover completely in 2 to 8 weeks. The former include ptosis, diplopia and blurred vision, asymmetrical forehead lines and drooping eyebrows, crooked corners of the mouth, poor eyelid closure, and tearing. Experienced botulinum toxin injectors can minimize the occurrence of side effects. Rare side effects include generalized flu-like symptoms or allergies. There are no specific dietary contraindications to botulinum toxin treatment, but combinations with medications that have neuromuscular junction functions, most commonly aminoglycoside antibiotics, should be avoided. Some patients have reported that alcohol consumption after botulinum toxin injection can reduce the efficacy of the drug and delay the onset of action. Although there is no clear clinical basis for this, patients should take appropriate care. For patients with primary facial muscle spasm, if their spasticity is severe, affecting their daily life and work, and they are strongly willing to have surgery, and the treatment with drugs or botulinum toxin is ineffective, then they can be considered for surgery. The efficiency of surgical treatment is 88%~97%. However, surgical therapy can lead to cranial nerve dysfunction, more serious complications such as brainstem cerebellar injury, hemorrhage, cerebrospinal fluid leakage, etc. There is a 0.1% surgery-related mortality rate, and the 2-year recurrence rate of patients is as high as 20%-25%. In the case of patients with blepharospasm, there is no curative surgical method available. In addition, menstruation in female patients is not an absolute contraindication to botulinum toxin treatment, but it will certainly increase the risk of bleeding and bruising at the injection site, so female patients are advised to avoid menstrual injections as much as possible. Generally speaking, patients who are taking aspirin or warfarin drugs are more likely to have local bruising than the general population, but botulinum toxin injections in the facial muscles are superficial, and as long as the doctor does a good job of stopping the bleeding with adequate pressure and paying attention to the injection method, the patient will generally not have a more serious hematoma. Discontinuing aspirin or warfarin, on the other hand, often puts patients at increased risk for cardiovascular disease, so in general, we do not recommend that patients discontinue these medications. Facial paralysis and facial stiffness caused by botulinum toxin injections are common side effects of the drug, which usually fade after 2 weeks. They are not the same disease as ordinary peripheral facial paralysis, and acupuncture treatment is generally not recommended.