A systematic review of Sandifer syndrome in children with severe gastroesophageal reflux

Topic overview

Key takeaways

• Sandifer syndrome combines gastroesophageal reflux with abnormal posturing, often mimicking neurological disorders and delaying diagnosis.
• All 56 reviewed cases improved with appropriate GER treatment; 79% without anatomical anomalies resolved with medical management alone.
• Patients with anatomical anomalies (hiatal hernia, malrotation) significantly more likely to require surgical fundoplication (p<0.001).
• Median time to symptom resolution with conservative treatment is 1 month; consider surgery if no improvement after this period.
• Primary care providers should include Sandifer syndrome in differential for abnormal posturing when neuromuscular causes are excluded.

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