Sandifer syndrome is defined by abnormal neurobehavioral movements in the context of hiatal hernia or gastroesophageal reflux disease (GERD) (1).
- Abnormal movements are often temporally associated with feedings and include the following:
- Head/eye version
- Extensor spasm
- Dystonic posturing
- Minimal jerking of the extremities
- Sandifer syndrome is underrecognized.
- Occurs in <1% of pediatric patients with GERD (1)
- Most common in male children, although infants and girls can be affected. Adult cases are rare.
- Commonly misdiagnosed as epilepsy (2)
Etiology and Pathophysiology
Movements are hypothesized to be a vagally mediated reflex response to esophageal acid exposure (3). The eosinophilic esophagitis from cow’s milk protein allergy may also be a cause of Sandifer syndrome (4).
Commonly Associated Conditions
- Cognitive impairment in older children and adults
- Hiatal hernia (1)
There's more to see -- the rest of this topic is available only to subscribers.
Domino, Frank J., et al., editors. "Sandifer Syndrome." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2020. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688667/all/Sandifer_Syndrome.
Sandifer Syndrome. In: Domino FJF, Baldor RAR, Golding JJ, et al, eds. 5-Minute Clinical Consult. Wolters Kluwer; 2020. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688667/all/Sandifer_Syndrome. Accessed May 31, 2023.
Sandifer Syndrome. (2020). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (27th ed.). Wolters Kluwer. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688667/all/Sandifer_Syndrome
Sandifer Syndrome [Internet]. In: Domino FJF, Baldor RAR, Golding JJ, Stephens MBM, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2020. [cited 2023 May 31]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688667/all/Sandifer_Syndrome.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Sandifer Syndrome ID - 1688667 ED - Domino,Frank J, ED - Baldor,Robert A, ED - Golding,Jeremy, ED - Stephens,Mark B, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688667/all/Sandifer_Syndrome PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -