Objective: This study investigates the correlation between
Apolipoprotein E gene (
APOE) polymorphism and the incidence and delayed resolution of
hemifacial spasms. Methods: The
APOE genotypes of 151 patients with
hemifacial spasm and 73 control cases were determined by cleaved amplification polymorphism sequence-tagged sites. The distribution of three
APOE alleles (ε2, ε3, and ε4) in two groups and the delayed resolution rate in 6 genotypes were calculated and statistically analyzed. Results: The proportion of patients with
APOE ε3/ε4 genotype in the
hemifacial spasm group (25.17%) was significantly higher than that in the control group (12.33%) (P = 0.027). In terms of allele frequency, the proportion of the
APOE ε4 allele in the
hemifacial spasm group (15.56%) was significantly higher than that in the control group (6.85%) (P = 0.009). Meanwhile, the proportion of
APOE ε4 allele carriers in the
hemifacial spasm group (29.80%) was significantly higher than that in the control group (13.7%) (P = 0.009). Logistic regression analysis showed that the ε4 allele significantly increased the incidence of
hemifacial spasm (OR 2.675, 95%CI 1.260-5.678, P = 0.010). Among the 32 patients with a delayed resolution, the ε3/ε3 and ε3/ε4 had the highest proportion in 6 genotypes. The delayed resolution rate of
APOE ε3/ε4 (34.21%) was significantly higher than
APOE ε3/ε3 (17.78%) (P < 0.05). The delayed resolution rate of
APOE ε4 carriers was the highest (33.33%) in the 3 allele carriers, but there was no significant difference among the 3 allele carriers (P = 0.065). Conclusion: The polymorphism of
APOE is relevant to the incidence rate of
hemifacial spasms.
APOE ε4 allele increases the incidence of
hemifacial spasm. The
APOE ε4 allele may promote the occurrence of delayed resolution.