the first patient with helps was reported in 2017. that single case report focused on the similarity of the motor symptoms between hemifacial spasm and hemi-laryngopharyngeal spasm. both conditions have unilateral involuntary motor contractions that are episodic, progressive, can occur while sleeping, can be ameliorated with botox, and cured by mvd. the patient also had episodic coughing which was not described in detail because it was not realized to be a fundamental part of the syndrome until more patients were studied. the original microscope images and video of the case were lost when the pentero microscope was upgraded before the data was transferred. ms. vicky earle provided profession illustrations of the anatomy for the publication.