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Purpose: Currently available grading and classification systems for hemifacial spasm either rely on subjective assessments or are excessively intricate. Here, we make use of facial recognition and facial tracking technologies towards accurately grouping patients according to severity and characteristics of the spasms., Methods: A retrospective review of our prospectively maintained preoperative videos database for hemifacial spasm was done. Videos were analyzed using an Apple AR kit-based App. A facial mesh is automatically allocated to specific biometric facial points. Videos are analyzed using Blender software for measuring the amplitude and frequency of the spasms. Classification of the patients into groups was done using both divisive k-means and agglomerative hierarchical clustering. Correlation-Analysis with preoperative quality of Life (Qol) using SF-36 questionnaire and HFS-8 score was performed. Additionally, correlation with postoperative outcome was calculated., Results: 79 preoperative videos were included. Both up-bottom and bottom-up clustering approaches grouped the patients into 3 different clusters according to 4 variables (eye closure, mouth distance change, rate, and repetition of the spasms). Correlation of the groups with the Qol was done for 46/79 patients (58.2%). Spasms could be classified into mild, moderate clonic and severe tonic spasms. Patients with mild spasms showed better Qol scores. Moderate clonic spasms experienced best outcomes following microvascular decompression., Conclusion: This novel classification using facial-tracking and augmented-reality is easy to use and apply. It quantifies the severity and type of the spasms and relates it to the quality of life of patients, postoperative outcome, and could guide our management strategy., Competing Interests: Declarations. Ethics approval: All procedures performed in this study involving human participants were in accordance with the ethical standards of the local institutional research committee (Ethical committee of the University Medicine Greifswald) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Ethical committee approval number BB 101/16. Informed consent was obtained from all patients including using their videos for research purposes. Consent for publication: “The Corresponding Author has the right to grant on behalf of all authors and does grant on behalf of all authors, a worldwide licence to the Publishers and its licensees in perpetuity, in all forms, formats and media (whether known now or created in the future), to i) publish, reproduce, distribute, display and store the Contribution, ii) translate the Contribution into other languages, create adaptations, reprints, include within collections and create summaries, extracts and/or, abstracts of the Contribution, iii) create any other derivative work(s) based on the Contribution, iv) to exploit all subsidiary rights in the Contribution, v) the inclusion of electronic links from the Contribution to third party material where—ever it may be located; and, vi) licence any third party to do any or all of the above.” Consent to participate: Although no data in this study could lead to public identification of the patients, all the participating patients signed consent to publication of their data. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Objective: Hydrocephalus is the most common brain disorder in children and is more common in low- and middle-income countries. Research output on hydrocephalus remains sparse and of lower quality in low- and middle-income countries compared with high-income countries. Most studies addressing hydrocephalus epidemiology are retrospective registry studies entailing their inherent limitations and biases. This study aimed to investigate child-related, parental, and socioeconomic risk factors of congenital hydrocephalus (CH) in a lower-middle-income country., Methods: An investigator-administered questionnaire was used to query parents of patients with CH and controls who visited the authors' institution from 2017 until 2021. Patients with secondary hydrocephalus and children older than 2 years of age at diagnosis were excluded. Uni- and multivariable logistic regression was performed to identify the factors affecting CH development., Results: Seven hundred forty-one respondents (312 cases and 429 controls) were included in this study. The authors showed that maternal diseases during pregnancy (OR 3.12, 95% CI 1.96-5.03), a lack of periconceptional folic acid intake (OR 1.92, 95% CI 1.32-2.81), being a housewife (OR 2.66, 95% CI 1.51-4.87), paternal illiteracy (OR 1.65, 95% CI 1.02-2.69), parental consanguinity (OR 3.67, 95% CI 2.40-5.69), a history of other CNS conditions in the family (OR 2.93, 95% CI 1.24-7.34), conceiving a child via assisted fertilization techniques (OR 3.93, 95% CI 1.57-10.52), and the presence of other congenital anomalies (OR 2.57, 95% CI 1.38-4.87) were associated with an independent higher odds of a child having CH. Conversely, maternal hypertension (OR 0.22, 95% CI 0.09-0.48), older maternal age at delivery (OR 0.93, 95% CI 0.89-0.97), and having more abortions (OR 0.80, 95% CI 0.67-0.95) were negatively correlated with CH., Conclusions: Multiple parental, socioeconomic, and child-related factors were associated with higher odds for developing CH. These results can be utilized to guide parental counseling and management, and direct social education and prevention programs.