{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T17:40:02Z","timestamp":1756316402479,"version":"3.44.0"},"reference-count":41,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,2,4]]},"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:p>We present a case of Sandifer syndrome in a 3-year-old girl who initially presented with a history of recurrent paroxysmal head drops associated with ataxia-like symptoms and recurrent falls sustaining a clavicular fracture on one occasion. She was referred to and seen by the paediatric neurologist. Physical examination, electroencephalogram, MRI brain, electromyograph single fibre study and blood tests were all normal. With the history of hiccups and choking-like episodes she was referred to the speech and language therapist (SALT). SALT assessment did not reveal indications of swallowing impairment or possible aspiration. A barium swallow later showed small amount of reflux into the distal oesophagus. This prompted a trial of lansoprazole and she was referral to the gastroenterologists. Endoscopy and oesophageal manometry were essentially normal. However, the pH impedance study revealed severe gastro-oesophageal reflux disease. She continued with lansoprazole and dairy-free diet and her symptoms resolved.<\/jats:p>","DOI":"10.1136\/bcr-2019-230989","type":"journal-article","created":{"date-parts":[[2020,3,5]],"date-time":"2020-03-05T04:05:14Z","timestamp":1583381114000},"page":"e230989","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Paroxysmal head drops with ataxia-like symptoms presenting as Sandifer syndrome in a 3-year old girl"],"prefix":"10.1136","volume":"13","author":[{"given":"Abubakar","family":"Sharif","sequence":"first","affiliation":[{"name":"Department of Paediatrics, Basildon and Thurrock University Hospital, Basildon, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucinda","family":"Carr","sequence":"additional","affiliation":[{"name":"Department of Paediatric Neurology, Great Ormond Street Hospital, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Efstratios","family":"Saliakellis","sequence":"additional","affiliation":[{"name":"Department of Paediatric Gastroenterology & Neurogastroenterology, Great Ormond Street Hospital, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Himadri","family":"Chakraborty","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Basildon and Thurrock University Hospital, Basildon, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,3,4]]},"reference":[{"key":"2025082710052123000_13.3.e230989.1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(94)90815-X"},{"key":"2025082710052123000_13.3.e230989.2","doi-asserted-by":"publisher","DOI":"10.1177\/1756285608095119"},{"key":"2025082710052123000_13.3.e230989.3","first-page":"219","article-title":"Proposed guidelines for the management of nodding syndrome","volume":"13","author":"Idro","year":"2013","journal-title":"Afr Health Sci"},{"key":"2025082710052123000_13.3.e230989.4","doi-asserted-by":"crossref","first-page":"1058","DOI":"10.1016\/S0140-6736(64)91264-4","article-title":"Hiatus hernia with contortions of the neck","volume":"1","author":"Kinsbourne","year":"1964","journal-title":"Lancet"},{"key":"2025082710052123000_13.3.e230989.5","doi-asserted-by":"publisher","DOI":"10.1136\/thx.37.8.634"},{"key":"2025082710052123000_13.3.e230989.6","first-page":"190","article-title":"Torsion spasms and abnormal postures in children with hiatus hernia Sandifer\u2019s syndrome","volume":"2","author":"Sutcliffe","year":"1969","journal-title":"Progr Pediat Radiol"},{"key":"2025082710052123000_13.3.e230989.7","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.1971.02100120089012"},{"key":"2025082710052123000_13.3.e230989.8","doi-asserted-by":"crossref","DOI":"10.1001\/archpedi.1977.02120180078015","article-title":"Torticollis with hiatus hernia in infancy. 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