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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.
KeywordsEarly Childhood Hiatal Hernia Reflux Disease Muscle Hypertrophy Rare Disorder
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.)