To investigate the prevalence and risk factors for cerebrovascular diseases (CVDs) in patients with hemifacial spasm (HFS), and explore the impact of early screening and prevention of CVDs on HFS progression.

Hemifacial spasm (HFS) is a neuromuscular disorder characterized by involuntary facial muscle contractions, often starting around the eye and progressing to other facial muscles. HFS is classified as idiopathic (due to vascular compression) or secondary (due to underlying conditions like tumors or stroke). The prevalence of HFS is 9.8 per 100,000, with a higher incidence in middle-aged women. Recent studies suggest a potential link between HFS and cerebrovascular diseases, especially hypertension, raising concerns about vascular health in these patients.

A retrospective analysis was conducted using the 2017-2018 Nationwide Inpatient Sample, including patients (aged 18–80 years) with clonic hemifacial spasm (ICD-10: G513, G5131, G5132, G5133, G5139) and categorized according to presenting symptom at admission as primary or secondary. Demographic, comorbidity, and cerebrovascular data were collected. Univariate and multivariate logistic regression models in R software evaluated the prevalence and risk factors for cerebrovascular diseases (CVD) in these patients, focusing on associations between age, sex, race, hospital factors, and cerebrovascular outcomes, to better understand CVD risks in this population.

In a cohort of 774 clonic hemifacial spasm patients (median age: 62 years), cerebrovascular disease (CVD) was present in 14.9%. CVD was significantly more prevalent in patients with secondary hemifacial spasm (21.5%) compared to primary (3.8%) (p<0.001). Cerebral infarction occurred more frequently in the secondary group (10.6% vs. 0.7%, p<0.001). Multivariate analysis showed that secondary hemifacial spasm (OR=5.15, p<0.001), age (OR=1.03, p=0.0004), and non-elective admissions (OR=2.35, p=0.003) were independently associated with increased CVD risk.