Sandifer syndrome is a rare paediatric medical disorder, characterised by gastrointestinal symptoms and associated neurological features. There is a significant link between the syndrome and gastro-oesophageal reflux disease (GORD), however it is estimated to occur in less than 1% of children with reflux.
Onset is usually confined to infancy and early childhood, with peaking at 18-36 months. In rare cases, particularly where the child is severely mentally impaired, onset may extend to adolescence.
The classic symptoms of the syndrome are nodding and rotation of the head, neck extension, gurgling, writhing movements of the limbs. Spasms may last for 1-3 minutes and may occur up to 10 times a day. Ingestion of food is often associated with occurrence of symptoms; this may result in reluctance to feed.
Diagnosis is made on the basis of the association of gastro-oesophageal reflux with the characteristic movement disorder. Neurological examination is usually normal. Misdiagnosis as benign infantile spasms or epileptic seizures is common, particularly where clear signs or symptoms of gastro-oesophageal reflux are not apparent. Early diagnosis is critical, as treatment is simple and leads to prompt resolution of the movement disorder.
Successful treatment of the associated underlying disorder, such as GORD or hiatal hernia, may provide relief.
Sandifer syndrome is not typically life-threatening and prognosis is good.