Sandifer Syndrome

Sandifer syndrome (SS) is a type of movement disorder that constitutes paroxysmal spasms of head, neck, and back arching but spares the limbs. SS is often associated with gastroesophageal reflux (GERD) in children. In addition, due to the abnormal posturing, parents may describe the dystonic episodes of SS as possible seizures. Therefore this causes great concern among parents and poses a diagnostic dilemma to the physicians. An increased number of these patients may obtain a referral to a pediatric neurologist for management of this condition leading to expensive diagnostic tests like MRI or EEG and antiepileptic medication management. Kotagal, et al. studied patients in an epileptic unit with an established diagnosis of an epileptic disorder and found that around 16% of them presented with GERD as the underlying cause, also, the average time of duration of symptoms and the length of treatment before a correct diagnosis was about one year. The primary care providers are urged to keep Sandifer syndrome in the differential diagnosis of nonepileptic paroxysmal dystonic events and abnormal posturing. A correct and timely diagnosis of SS leads to the complete resolution of the symptoms.