Sandifer's syndrome is a group of movement disorders found in children with gastro-intestinal reflux. The main symptom of the disease is pouring food and paroxysmal, sudden bending of the head to the side or back. How to recognize Sandifer syndrome and how to distinguish it from epilepsy? What is Sandifer's syndrome?

Sandifer's syndromeis a disease whose mechanism has not yet been understood. The main symptom of this disorder is the child's pouring of food.

Some children with Sandifera Syndrome don't rain that often. Their diagnosis is particularly difficult.

The downpouring itself is a natural phenomenon and applies to almost all newborns and infants, and is related to the still immature digestive system. However, at some point your baby should stop raining down - usually around 6 months of age, when he starts to sit up. Children with longer rushing time are often diagnosed with acid reflux disease. On the other hand, about 1% of children with reflux develop Sandifer's syndrome. The first symptoms appear between 8 and 36 months of age.

Symptoms of Sandifer's syndrome

After months of downpouring and vomiting, a child with reflux may develop disturbing movement disorders, mainly:

  • sudden neck bends, torticollis
  • the child suddenly tilts its head back or presses it against the shoulder; this movement may occur in series, even resemble epileptic movements; as a rule, but not exclusively, it happens while eating
  • changes in facial expressions - while eating, the child may look paralyzed or grimace for a while
  • very strong, often violent, tilted heads towards the back during sleep; the baby gives the impression that he wants to touch the back of his neck

It is suspected that these movements, called dystonic movements, are the child's reaction to unpleasant, even painful sensations when the stomach contents regurgitate (in Sandifer's esophageal pH drops below 4). It may be an intuitive defensive reflex the patient has learned to deal with the discomfort of reflux episodes. The movements described above accelerate the esophageal peristalsis and increase the frequency of its contractions. Esophagushe cleans himself of undesirable content faster and the patient feels relief.

Another underlying hypothesis for these movements points to the vagus nerve. Gastric content that enters the lower esophagus irritates the vagus nerve endings and along the way of the reflex arc from the center in the nucleus of the solitary strand, it may stimulate contraction of the sternoclavicular and trapezius muscles, as well as cause e.g. the turning of the eyeballs upwards. in children with Sandifer's syndrome the following may occur:

  • anemia
  • malnutrition
  • heartburn
  • nausea
  • chronic cough
  • recurrent bronchitis and pneumonia
  • breathing disorders, sleep apnea
  • anxiety
Worth knowing

What is the difference between a downpour and acid reflux disease?

The downpour is nothing dangerous. It is an inconspicuous, physiological phenomenon that does not cause the child any pain that is not treated and passes by itself. Reflux disease is when food and gastric juices from the stomach go back to the esophagus, causing its irritation and constant heartburn. In the extreme - when the downpouring is abundant - the child does not gain weight. The cause of reflux is a malfunction of the muscle - the lower esophageal sphincter, which is located between the esophagus and the stomach.

Diagnosis of Sandifer's syndrome

Sandifer's syndrome is sometimes confused with epilepsy. What's worse, in this case, he is treated with antiepileptic drugs, which are not able to help the child, but can only harm. Thus, the fundamental issue in the diagnosis of Sandifer's syndrome is the neurological examination of the child and the exclusion of epilepsy. A child with Sandifer's syndrome should have:

  • valid EEG
  • proper fundus examination
  • normal development - development regression in patients with epilepsy
  • belching and pouring down not only after eating
  • reluctance to eat or vice versa - excessive appetite (eating causes masking the unpleasant effects of the disease - burning in the throat)
  • choking on food, even in the middle of the night, while sleeping, without any announcement
  • Older infants and children who spend most of the time in an upright position experience unexpected rainfall, even long after a meal (2-3 hours). It is also characteristic for children with Sandifer Syndrome that they are visibly trying to fight the gag reflex, they constantly swallow and smack something.
  • reluctance to lie down - children transported in prams on a walk often rebel and scream, and only calm down when they eatto pick up

Sandifer's syndrome is confirmed by 24-hour pH-measurement - a study assessing how often and how much stomach acid enters the esophagus.

Important

Sandifer's syndrome can occur not only in gastro-oesophageal reflux disease, but also in hiatal hernia and oesophageal oversensitivity.

Sandifer's syndrome - treatment

A child with a suspected Saandifer syndrome should be looked after by a pediatric gastroenterology clinic. Proton pump inhibitors are used in the treatment, for several weeks - up to several months. They usually lead to complete relief of symptoms or at least improve.

This will be useful to you

A child with Sandifer Syndrome can be relieved in several ways. First of all, you should put them to sleep at an angle so that the head is higher than the legs - you can, for example, put something under the legs of the bed on one side. It is not recommended to water before bedtime or at night. If the child does not want to lie down, as often as possible carry it on your arms, and place or arrange it in the stroller so that the torso is slightly raised.

Category:

Neurology