Sandifer syndrome

Sandifer syndrome is a movement disorder that comprises paroxysmal retrocollis(extension of neck) and  opisthotonus(arching/extension of trunk) posturing with tonic deviation of neck in early child hood due to gastroesophageal reflux. The child has preserved consciousness during the episode.

It occurs in early childhood and neurologic development is normal in most patients. 

It is often confused with dystonias and seizures.  Video EEG is helpful. 

These patients may have associated  hiatal hernia. Antireflux treatment should always be given and surgical treatment (fundoplication) should be performed if medical treatment alone is not helpful.

Read classification of ” Paroxysmal Non Epileptic Events PNEE

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