Sandifer's Syndrome
Gastroesophageal reflux is a common problem in infancy and childhood. However, it may be overlooked as a cause or complication of respiratory disease and/or neurobehavioral problems. In this report of a 5-year-old child with cerebral palsy, severe developmental delay, and asthma, Sandifer's syndrome was diagnosed after she was found to have gastroesophageal reflux disease (GERD). Awareness of GERD and Sandifer's syndrome may spare neurologically impaired children from persistent symptoms and delayed appropriate treatment.
Patients at Risk for pathologic gastroesophageal reflux include premature infants, children with respiratory disorders such as asthma and cystic fibrosis, and those with central nervous system (CNS) disorders such as cerebral palsy. In a previous case report by Bray et al, children with gastroesophageal reflux had complaints that suggested a CNS problem. In all cases, symptoms began in early infancy, but the ultimate diagnosis and treatment were delayed until 5 years of age in some patients. This case report describes a 5-year-old neurologically impaired child with asthma who had delay in the diagnosis and treatment of gastroesophageal reflux. After antireflux medication was started, the seizure-like episodes ceased, and asthma symptoms markedly improved.
Abstract
Gastroesophageal reflux is a common problem in infancy and childhood. However, it may be overlooked as a cause or complication of respiratory disease and/or neurobehavioral problems. In this report of a 5-year-old child with cerebral palsy, severe developmental delay, and asthma, Sandifer's syndrome was diagnosed after she was found to have gastroesophageal reflux disease (GERD). Awareness of GERD and Sandifer's syndrome may spare neurologically impaired children from persistent symptoms and delayed appropriate treatment.
Introduction
Patients at Risk for pathologic gastroesophageal reflux include premature infants, children with respiratory disorders such as asthma and cystic fibrosis, and those with central nervous system (CNS) disorders such as cerebral palsy. In a previous case report by Bray et al, children with gastroesophageal reflux had complaints that suggested a CNS problem. In all cases, symptoms began in early infancy, but the ultimate diagnosis and treatment were delayed until 5 years of age in some patients. This case report describes a 5-year-old neurologically impaired child with asthma who had delay in the diagnosis and treatment of gastroesophageal reflux. After antireflux medication was started, the seizure-like episodes ceased, and asthma symptoms markedly improved.
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