Sandifer syndrome entities

Clinic

• Sandifer syndrome is an eponymous paediatric medical disorder, characterized by GI symptoms and associated neurological features.
• There is a significant correlation between the syndrome and gastro-oesophageal reflux disease (GORD); however, it is estimated to occur in less than 1% of children with reflux.

Symptoms / Signs

• Onset is usually confined to infancy and early childhood, with peak prevalence at 18–36 months.
• The classical symptoms of the syndrome are spasmodic torticollis and dystonia.
• Nodding and rotation of the head, neck extension, gurgling, writhing movements of the limbs
• Severe hypotonia
• 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.
• Associated symptoms / signs are
  • Epigastric discomfort, vomiting (which may involve blood)
  • Abnormal eye movements have been reported.
  • Anaemia

Miasms

PLV: Hypotonia + Spasm + Gastric Dilation