Sandifer Syndrome

Christina Conrad, D.O. Reviewed 04/2024

BASICS

DESCRIPTION

Sandifer syndrome is a rare complication of gastroesophageal reflux disease (GERD) when a patient presents with extraesophageal symptoms, typically neurological (1).

Abnormal moveme...

DIAGNOSIS

HISTORY

History is the most important aspect of diagnosing Sandifer syndrome.

Abnormal movements 30 minutes after feeding
Poor feeding
Vomiting
No mental status changes
No postictal depression

PHYSICAL EXAM

TREATMENT

Focuses on resolving the underlying condition of GERD. If GERD is suspected or diagnosed, research recommends starting with the standard treatment approach for GERD in children, as outlined ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

If symptoms do not resolve with treatment of GERD, refer to a neurologist for video-EEG to look for seizures.

PROGNOSIS

Sandifer syndrome resolves once the GERD is...

REFERENCES

Mindlina I. Diagnosis and management of Sandifer syndrome in children with intractable neurologic symptoms. Eur J Pediatr. 2020;179(2):243–250.

Bamji N, Berezin S, Bostwick H, et al. Treat...

ADDITIONAL READING

Rosen R, Vandenplas Y, Singendonk M, et al. Pediatric gastroesphageal reflux clinical practice guidelines: Recommendations of the North American Society for Pediatric...

CODES

ICD10

M43.6 Torticollis

SNOMED

230314007 Sandifer syndrome

CLINICAL PEARLS

Sandifer syndrome is underrecognized and often misdiagnosed as epilepsy.
History is the most important aspect of diagnosing Sandifer syndrome.
Sandifer syndrome is commonly associated wi...

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