Why Does My Baby Keep Throwing His Head Back
Sandifer syndrome is a movement disorder that affects infants. Babies with Sandifer syndrome twist and arch their backs and throw their heads back. These strange postures are cursory and sudden. They commonly occur subsequently the baby eats. Symptoms usually resolve within before the baby turns ii.
Sandifer syndrome is thought to exist rare. Researchers cannot approximately how many people have the condition. There are 2 reasons why that number remains elusive. First, Sandifer syndrome is frequently misdiagnosed because and so many of the the symptoms are markers for other conditions. Symptoms can resemble seizures, infantile spasms, infant torticollis, a muscular status, and paroxysmal dystonia, another movement disorder that also sees attacks of abnormal posturing. When you combine not-specific symptoms with a relatively rare condition, you will get a lot of misdiagnosed cases.
An aspect of Sandifer syndrome that aids in diagnosis is its frequent coincidence with feeding the baby, gastroesophageal reflux, esophagitis, and hiatal hernia. These issues involving the upper digestive tract together with characteristic twisting postures indicate that a baby has Sandifer syndrome. Sandifer syndrome and gastroesophageal reflux disease are closely related.
What Are the Symptoms of Sandifer Syndrome?
In a typical attack of Sandifer syndrome, a babe's back will arch suddenly. With their back flexed, their head and legs also splay out backward. They become stiff. Other expressions of the syndrome include nodding caput movements, twisting or tilting of the head, or thrashing limbs. Many babies also showroom involuntary eye movements.
During these episodes, babies may get quiet, every bit if they have suddenly entered a different land of listen. They may also announced uncomfortable or cry. Episodes normally concluding a minute or two only will recur up to x times a day. The baby will stiffen, then relax, and and so stiffen again, a pattern that resembles seizures.
Along with abnormal movements, babies with Sandifer syndrome may have symptoms of gastroesophageal reflux disease. More unremarkably known as GERD, acid reflux, or heartburn, gastroesophageal reflux is expected in babies. It is normal for babies to vomit frequently with GERD. However, babies with gastroesophageal reflux affliction will have symptoms like fussiness, coughing, and weight loss.
Due to its human relationship with gastroesophageal reflux disease, episodes of Sandifer syndrome most commonly occur afterward eating. They practise not occur when the child is asleep.
Hiatal hernias sometimes back-trail Sandifer syndrome. A hernia happens when an organ pushes through an opening in its protective environs into an area it isn't supposed to be. With a hiatal hernia, the upper tummy pushes up through the hiatus, the opening between the esophagus and the breadbasket.
This tin can happen when the musculus is weakened due to an injury, aging, or strain. It is also possible to be born with an abnormally large hiatus. A hiatal hernia unremarkably results in acid reflux, which, again, is related to the development of Sandifer syndrome.
- Why babies curvation their backs and cry - Sandifer'south Syndrome is over diagnosed by parents and under-diagnosed by doctors
- New 2020 report on Sandifer's Syndrome
What Causes Sandifer Syndrome?
Nosotros do not know what causes Sandifer'due south syndrome. We do know in that location is a close human relationship betwixt Sandifer syndrome and gastroesophageal reflux disease. The nature of that relationship is non fully understood by researchers. But it has led to hypotheses that hint at the origin of Sandifer syndrome and its handling.
It has been shown that there is an association between the occurrence of reflux and the occurrence of Sandifer symptoms.[ane] Researchers hypothesize that contorted postures might be the Sandifer baby's pathological response to acid reflux. An arched and stretched position may salvage the pain and discomfort of the reflux.[2],[3]
Babies can get gastroesophageal reflux disease in the showtime identify due to the immaturity of the muscle that prevents the tummy's contents from going upward into the esophagus. The muscle relaxes when it should exist tightly closed, causing heartburn and vomiting. A hiatal hernia, when the tummy pushes up into the chest cavity, can besides cause reflux. Babies are more susceptible to reflux because they consume a liquid diet.
An allergy to cow'south milk has likewise been linked to Sandifer'southward syndrome. Infants are exposed to cow's milk through breast milk and formula. (Milk protein allergy is also a differential diagnosis.) For infants who don't reply to normal handling, a hypoallergenic formula might be the answer.[four]
Who Is Affected by Sandifer Syndrome?
Infants make up the majority of people afflicted past Sandifer syndrome. Most infants, after being treated for gastroesophageal reflux disease, no longer feel symptoms.
However, when Sandifer syndrome persists as a kid grows older, their symptoms are likely linked to another neurological or move condition. This is a condition yous want to diagnose every bit soon as possible.
How Is Sandifer Syndrome Diagnosed?
To diagnose Sandifer syndrome, a physician will ask most your baby's behavior and perform a concrete examination. An MII test (multichannel intraluminal impedance) test measures the flow of fluids, air, and solids in the esophagus. Doctors practice this examination, forth with pH testing, using a catheter probe in club to diagnose gastroesophageal reflux.
The doctor may likewise perform tests to rule out other conditions. For example, a CT browse will reveal whatsoever muscle abnormalities and video-EEG monitoring will show any seizure activity.
Sandifer syndrome is normally misdiagnosed as seizures or a neurological movement disorder. Symptoms tin resemble seizures, infantile spasms, infant torticollis, a muscular condition, and paroxysmal dystonia, a motility disorder that also sees attacks of abnormal posturing.
Misdiagnosis can happen when the baby only has mild symptoms, or no outward symptoms at all, of gastroesophageal reflux disease. In the absence of those symptoms, a md may aspect the baby's abnormal postures to another cause.
Furthermore, postures and movements are not consistent across cases. Some babies may arch their back while others tilt their necks, for instance, making it difficult to recognize Sandifer syndrome.
Incorrect diagnoses are harmful considering they subject the baby to unnecessary testing and medication that can take unsafe side effects. This is not only expensive and emotionally taxing for parents but likewise deprives the baby of constructive treatment.
How Is Sandifer Syndrome Treated?
Virtually of the time, Sandifer syndrome goes abroad within the starting time ii years of a infant's life. Given the link to gastroesophageal reflux illness, handling revolves around treating the reflux itself. This tin can include changes to the baby's nutrition and eating habits, medication, and surgery. Addressing gastroesophageal reflux disease eliminates the symptoms of Sandifer syndrome.
Parents tin feed their baby less food more frequently and thicken their food with cereal. They tin can besides keep their baby in an upright position after eating. Gravity volition assistance go along the contents of their stomach from coming up into the esophagus. Babies also benefit from time spent playing on their stomach, under close supervision, in order to promote the healthy development of muscles and movement.
There are several categories of medications used to care for gastroesophageal reflux disease. Antacids neutralize tum acid in order to reduce the burning feeling of heartburn and the pressure level of indigestion. Other drugs decrease the corporeality of breadbasket acrid that the body tin produce.
Histamine H2 antagonists prevent acrid-producing cells in the tum lining from responding to histamine, a chemical that would normally prompt the acid-producing cells to release acid. Alternatively, proton pump inhibitors block the "proton pump" enzyme, the mechanism by which acrid is secreted from the interior of the acid-producing prison cell out into the breadbasket.
Rarely, surgery is required to improve gastroesophageal reflux. A surgery called "fundoplication" is available to patients who do non answer to lifestyle changes or medication. In fundoplication surgery, the top of the stomach is wrapped around the bottom of the esophagus.
Suturing the stomach around the esophagus tightens the opening between the two organs, preventing the contents of the tummy from moving upwards into the esophagus. Surgery is sometimes needed to repair a hiatal hernia, which tin be washed at the same fourth dimension as the fundoplication.
Information technology is not a procedure you wanted performed on your kid unless it is absolutely necessary. Nevertheless, this surgery has a high rate of satisfaction, resulting in a good outlook for patients with Sandifer syndrome.
Sandifer Syndrome
- Sandifer syndrome-Medscape
- Sandifer Syndrome-National Institutes of Health
- Gastroesophageal reflux
- Gastroesophageal reflux medications
- Fundoplication
Like and Related Atmospheric condition
- Babe seizures
- Infantile spasms
- Paroxysmal Dystonia
- Esophagitis
- Hiatal hernia
Scientific Publications
"Diagnosis and direction of Sandifer syndrome in children with intractable neurological symptoms" past Irina Mindlina, European Journal of Pediatrics, 2020
"Sandifer Syndrome Posturing: Relation to Intestinal Wall Contractions, Gastroesophageal Reflux, and Fundoplication" by Eric Frankel et al, Digestive Diseases and Sciences, 2006.
"Sandifer's Syndrome" by Roongroj Bhidayasiri and Daniel Tarsy, Motility Disorders: A Video Atlas, 2012.
"Treatment of Sandifer Syndrome with an Amino-Acid-Based Formula" past Natasha Bamji et al., AJP Reports, 2015.
[1] "Sandifer Syndrome Posturing: Relation to Intestinal Wall Contractions, Gastroesophageal Reflux, and Fundoplication" by Eric Frankel et al, Digestive Diseases and Sciences, 2006.
[2] "Sandifer's Syndrome" by Roongroj Bhidayasiri and Daniel Tarsy, Motility Disorders: A Video Atlas, 2012.
[3] "National Institutes of Health"
[iv] "Handling of Sandifer Syndrome with an Amino-Acid-Based Formula" by Natasha Bamji et al., AJP Reports, 2015.
Source: https://www.birthinjuryhelpcenter.org/sandifer-syndrome.html