Sandifer Syndrome

Sandifer syndrome a rare disorder that usually affects children up to the ages of 18 to 24 months. It causes unusual movements in a child’s neck and back that sometimes make it look like they’re having a seizure. However, these symptoms are usually caused by severe acid reflux, or gastroesophageal reflux disease (GERD).

The main symptoms of Sandifer syndrome are torticollis and dystonia. Torticollis refers to involuntary movements of the neck. Dystonia is a name for writhing and twisting motions due to uncontrollable muscle contractions. These movements often cause children to arch their backs.

Additional symptoms of Sandifer syndrome and GERD include:

  1. • head nodding
  2. • gurgling sounds
  3. • coughing
  4. • trouble sleeping
  5. • poor weight gain
  6. • choking
  7. • breath-holding spells
  8. • slow feeding
  9. • recurrent pneumonia

The exact cause is unknown.However, it’s almost always related to a problem with the lower oesophagus, which leads into the stomach, or a hiatal hernia. Both of these can lead to GERD.GERD often causes chest pain and throat discomfort, and studies suggest that the movements associated with Sandifer syndrome are simply a child’s response to pain or way of relieving discomfort.

Electroencephalogram (EEG) to look at electrical activity in the brain.
If the EEG doesn’t show anything unusual, the doctor might do a pH probe by inserting a small tube down your child’s oesophagus. This checks for any signs of stomach acid in the oesophagus over 24 hours. The probe might require an overnight hospital stay

Treating Sandifer syndrome involves trying to reduce symptoms of GERD. In many cases, we need to make some changes in feeding habits.These include:

  1. • Not overfeeding
  2. • Keeping your child upright for a half-hour after feeding
  3. • Using a hydrolysed protein formula if formula feeding or eliminating all dairy from diet
  4. • Mixing up to 1 tablespoon of rice cereal for every 2 ounces of formula in the baby bottle

If none of these changes work, doctor might suggest medication, including:

  1. • H2 receptor blockers, such as ranitidine (Zantac)
  2. • antacids, such as Tums
  3. • proton pump inhibitors, such as lansoprazole (Prevacid)

In rare cases, child may need a surgical procedure called Nissen fundoplication. This involves wrapping the top of the stomach around the lower oesophagus. This tightens the lower oesophagus, which prevents acid from coming up into the oesophagus and causing pain.

By – Tutor – Ms. Annu Panchal
Department of Nursing
College Of Nursing UCBMSH
Uttaranchal (P.G.) College Of Bio-Medical Sciences & Hospital

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