Sandifer’s syndrome: symptoms, causes and treatments

A disease typical of childhood that affects the digestive system.

The human body is a complex organism, possessing different systems dedicated to various vital functions for our survival and that generally act in a coordinated and correct way.

One of these systems is the digestive system, thanks to which we can incorporate nutrients necessary for survival. However, sometimes this and other body systems can present problems or alterations such as malformations or intolerances, or various diseases, injuries and disorders can come into action.

Sandifer syndrome is one such disorder, which occurs during infancy and causes a variety of symptoms, although it is not considered dangerous for the child.It is not considered dangerous for the child.

Sandifer syndrome: description and symptoms

Sandifer's syndrome is a disorder often referred to as a paroxysmal motor disorder, in which motor symptoms derived from disturbances in the digestive system appear.. It is a disease that appears in children and especially during the first years of life although it can appear at any time between birth and adolescence, being frequent that the age of appearance is around eighteen months of age.

Children with Sandifer syndrome experience jerks and spasms lasting several minutes (usually between one and three) in areas such as the head, arms or legs with hyperextensions and various rotations. They often cause torticollis, rigid postures and arching of the back. And in some cases obstructive apnea also appears. These motor disturbances may appear at different times of the day, but tend to appear especially after ingestion and generally cease during sleep.

In this sense, another main symptom is the presence of esophagitis, or inflammation of the esophagus. They frequently present anemia caused by iron deficiency, lack of appetite and dysphagia, vomiting and abdominal pain.. Hypotonia, weakness and fatigue may also appear.

Causes of this disease

The etiology of Sandifer's syndrome is considered to be in the digestive tract. Generally, it is associated with the presence of reflux during digestion, partially regurgitating food as it passes from the stomach into the esophagus.

Another possible cause occurs when the infant suffers from a hiatal hernia, in which a part of the digestive tract is partially regurgitated.In this case, a part of the digestive tract protrudes through the diaphragm and becomes located in the thorax instead of in the abdomen. This can cause pain in the child, and in turn cause the aforementioned reflux.

It is speculated that in many cases the Muscle spasms are a consequence of an attempt to decrease the level of pain caused by gastroesophageal reflux.

Although the symptoms appear to be neurological, as a general rule at the cerebral level the child presents neurotypical neuronal activity, with no alterations observed at the electroencephalogram level. Thus, Sandifer syndrome would not be caused by a cerebral or nervous problem, the spasms not being epileptic seizures (with which this disorder is often confused).

Behavioral alterations

Although Sandifer's syndrome does not imply the existence of behavioral alterations, it must be taken into account that depending on its duration and time of onset, the pain derived from the problems that generate it can generate in the child a certain conditioned fear of eating. This can cause problems such as limited feeding or refusal to eat, although in the long run this fear can be extinguished as food intake occurs without pain.

Also the presence of anemia can cause inactivity and lack of motivation in the childand sleep disturbances that can range from insomnia to hypersomnia.

Treatments

Sandifer syndrome is a disorder whose prognosis is positive and presents a good level of recovery.It is rare that there are severe complications for the child. However, it is important that there is an early diagnosis to prevent possible problems and seek a treatment that eliminates or reduces the problem of the digestive system that generates it.

In this sense, we seek to treat the problem that generates the syndrome. Usually a treatment for gastroesophageal reflux is established, in which pharmacologically the level of stomach acidity is caused to decrease. Also a surgical procedure may also be required if it is due to a hiatal hernia or if the reflux treatment is not effective.

In addition to this other possible symptoms such as iron deficiency anemia should be treated, and inflammation should be reduced in cases of esophagitis.

Bibliographic references:

• López, J.M. (1999). Paroxysmal motor disorders. Rev Neurol; 28(161):89-97.
• Quintero, M.I.; López, K.; Belandria, K.; Navarro, D. (2012). Sandifer syndrome. Apropos of gastroesophageal reflux disease in children. Gen 66(2). Caracas
• Sherman, P. et al. (2009). A Global, Evidence-Based Consensus on the Definition of Gastroesophageal Reflux Disease in the Pediatric Population. Am. J. Gastroenterol., 104:1278-1295.