Sandifer’s Syndrome

Part of the Current Clinical Neurology book series (CCNEU)


Sandifer’s syndrome refers to a disorder which causes gastro-esophageal reflux and abnormal posturing. Although the precise mechanism is unclear, it is hypothesized that the positioning of the head and upper extremities adopted by the affected child provides relief from the abdominal discomfort caused by acid reflux. Thought to be a rare disorder, Sandifer’s syndrome typically occurs during infancy and early childhood. The abnormal movements are usually manifest as nodding head movements, rotations and extension postures of the head and neck, gurgling sounds, writhing movements of the limbs, and severe hypotonia. Intermittent stiff tonic postures and episodic crying and discomfort may suggest seizures, although evidence to support this possibility is lacking.


Early Childhood Hiatal Hernia Reflux Disease Muscle Hypertrophy Rare Disorder 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

Sandifer’s syndrome.mp4 (MP4 8,858KB)

The patient exhibits severe truncal flexion while standing, walking, and drawing in a crouched position with his head hanging downward. He was alert throughout the episode. (Video contribution from Dr. Asha Kishore, Sree Chitra Tirunal Institute for Medical Sciences and Technology, India.)


  1. 1.
    Kinsbourne M. Hiatus hernia with contortions of the neck. Lancet. 1964;13:1058–61.CrossRefGoogle Scholar
  2. 2.
    Frankel EA, Shalaby TM, Orenstein SR. Sandifer syndrome: relation to abdominal wall contractions, gastroesophageal reflux, and fundoplication. Dig Dis Sci. 2006;51:635–40.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  1. 1.Chulalongkorn Center of Excellence on Parkinson’s Disease and Related DisordersChulalongkorn University HospitalBangkokThailand
  2. 2.Department of NeurologyDavid Geffen School of Medicine at UCLALos AngelesUSA
  3. 3.Department of NeurologyHarvard Medical School Beth Israel Deaconess Medical CenterBostonUSA

Personalised recommendations