WHAT IS SANDIFER'S SYNDROME?
Sandifer's Syndrome is described as spastic ╣torticollis
and ▓dystonic body movements found in
infants and children and associated with Gastroesophageal Reflux Disease.
Sandifer's syndrome is commonly mistaken for seizures but thankfully, has
no neurological basis whatsoever. Usually you can tell the
difference between Sandifer's and seizures as Sandifer's syndrome symptoms
will generally appear after feeding time.
WHAT ARE THE SYMPTOMS OF SANDIFER'S SYNDROME?
- Nodding and rotation of the limbs
- Neck extension
- Gurgling sounds
- Writhing movements of the limbs
- Severe │hypotonia
- Seizure like appearance and apparent altered mental state
The child may have a sudden rotation of the head and neck to one side
and the legs to the other with a stretched out appearance.
Typically, the back is arched backwards with hyperextension of the spine.
Elbows may be flexed and held backwards with hyperextended hips.
During the posture, the infant may become quiet and fussiness will
generally start as the posture lessens.
True Sandifer's syndrome is not to be confused with the regular type of
back arching that is common in babies with reflux and GERD. It is
quite common for babies with reflux to arch their necks and backs in a
backward position but this type of back arching is quite different than
true Sandifer's syndrome as it doesn't include the above mentioned
postures as well.
WHAT CAUSES SANDIFER'S SYNDROME?
It is thought to be somewhat of a defense mechanism some babies develop
in effort to cope with the pain of repeated acid reflux. It's been
suggested that tilting the head to one side is an unconscious effort to
reduce reflux episodes or simply provide relief from discomfort.
Esophageal manometry has also shown improvements in peristalsis (gastric
contractions) when the head is tilted. It's also thought that this
posturing may help to clear acid from the bottom of the esophagus.
HOW IS SANDIFER'S SYNDROME DIAGNOSED?
Parental report of symptoms may be enough to diagnose Sandifer's. Some
parents report taking video tapes of their child's posturing to their
doctor and receiving a diagnosis in this manner. If seizures are
suspected an EEG and/or CT-scan may be performed to rule out the
possibility of seizures or other neurological abnormalities. As
well, a ph-probe may be conducted to positively identify acid exposure to
HOW IS SANDIFER'S SYNDROME TREATED?
Treating Sandifer's syndrome must be done by treating the underlying
cause, the baby's reflux or GERD. Once a successful treatment
regimen is put into place for the child's GER, and the baby begins to feel
relief from the discomfort and pain of acid in the esophagus, the symptoms
and thus, syndrome will diminish with no long term side effects.