title: [Sandifer's syndrome in a 5-month-old child with suspicion of infantile spasms].
abstract: Sandifer's syndrome is a dystonic movement disorder in infants with gastroesophageal reflux (GER). It is probably misdiagnosed as epileptic seizures. We report the case of a 5-month-old infant with no past medical history admitted to a pediatric unit for suspicion of infantile spasms. She presented with dystonic movements of the upper left limb with left blepharospasm and an occasional dystonic head posture. Physical examination, EEG, brain MRI, and blood analysis were normal. Since the baby experienced regurgitations, Sandifer's syndrome was suspected and confirmed by 24-h esophageal pH monitoring that documented pathological GER. The dystonic symptoms quickly disappeared under treatment with thickened infant formula and sodium alginate. Infantile spasms remain the first diagnosis to explore with axial or para-axial dystonic postural events. Sandifer's syndrome should be retained when neurological investigations are normal and abnormal movements disappear under treatment of proven GER. Prognosis is excellent.
authors.affiliation: Pôle enfant, service de médecine infantile et génétique clinique, centre hospitalier universitaire, rue du Morvan, 54500 Vandœuvre-lès-Nancy, France. Electronic address: maelle.wirth@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Wirth
authors.affiliation: Pôle enfant, service de médecine infantile et génétique clinique, centre hospitalier universitaire, rue du Morvan, 54500 Vandœuvre-lès-Nancy, France; Pôle enfant, centre de référence des maladies héréditaires du métabolisme, centre hospitalier universitaire, rue du Morvan, 54500 Vandœuvre-lès-Nancy, France.
authors.forename: C
authors.initials: C
authors.lastname: Bonnemains
authors.affiliation: Pôle enfant, service de médecine infantile et génétique clinique, centre hospitalier universitaire, rue du Morvan, 54500 Vandœuvre-lès-Nancy, France.
authors.forename: J
authors.initials: J
authors.lastname: Auger
authors.affiliation: Pôle enfant, service de médecine infantile et génétique clinique, centre hospitalier universitaire, rue du Morvan, 54500 Vandœuvre-lès-Nancy, France.
authors.forename: E
authors.initials: E
authors.lastname: Raffo
authors.affiliation: Pôle enfant, service de médecine infantile et génétique clinique, centre hospitalier universitaire, rue du Morvan, 54500 Vandœuvre-lès-Nancy, France.
authors.forename: B
authors.initials: B
authors.lastname: Leheup
mesh_terms: D003937:Diagnosis, Differential; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D007223:Infant; D013036:Spasms, Infantile / Q000175:diagnosis* / Q000209:etiology; D014103:Torticollis / Q000150:complications / Q000175:diagnosis*