Sandifer syndrome: the mis-interpretable disorder

Abstract

Sandifer syndrome (SS), a movement disorder which is characterised by spasmodic torsional dystonia with back arching and rigid opisthotonic posturing, negatively impacting predominantly the neck, back, and upper extremities. Symptomatic gastro-esophageal reflux disease, esophagitis, or the presence of a hiatal hernia are all associated with Sandifer syndrome. The cause of Sandifer syndrome being uncertain, lifestyle adjustments and modifications highlights as the appropriate mode of treatment. To treat the condition and help relax the baby after feeding, dietary changes or medications can be administered. The case report of a patient with Sandifer Syndrome is considered for observation. Upon arrival, the child was stable, and an Electro-encephalogram (EEG) test revealed nothing abnormal. The child was taking several Anti-epileptic drugs (AED’s), which were stopped in favour of Sodium valproate and Pyridoxine.  An opinion from a Gastro-enterologist was sought in light of the epilepsy and possible Gastro-esophageal reflux disease (GERD), and they suggested a milk scan. Rantac was then started, and breastfeeds were thickened. Milk can indicate mild GERD and a reduction in episode frequency. So, sodium valproate was discontinued. Haemodynamically stable child was discharged from the hospital with Pyridoxine and Carnisure. Studies shows most cases of SS improve over time, within the first 24 months in general.