PDF(Pubmed)
Abstract：
OBJECTIVE: Sandifer syndrome (SS), which combines gastroesophageal reflux (GER) and a neurological or psychiatric disorder, is an uncommon condition that often takes a long time to diagnosis. We aimed to systematically review available papers regarding SS.
METHODS: After presenting our two cases of SS, we systematically reviewed articles published in MEDILINE/PubMed, Cochrane Library, and Web of Science.
RESULTS: The meta-analysis included 54 reported cases and 2 of our own cases. Our results showed that all cases achieved symptom improvement with appropriate treatment for GER. Notably, 19 of the 56 cases exhibited anatomical anomalies, such as hiatal hernia and malrotation. Significantly more patients with than without anatomical anomalies required surgery (p < 0.001). However, 23 of the 29 patients without anatomical anomalies (79%) achieved symptom improvement without surgery. Patients who did not undergo surgery had a median (interquartile range) duration to symptom resolution of 1 (1-1) month.
CONCLUSIONS: The primary care providers should keep SS in the differential diagnosis of patients presenting with abnormal posturing and no apparent neuromuscular disorders. Fundoplication may be effective especially for patients with anatomical anomalies or those whose symptoms do not improve after more than 1 month with nonsurgical treatment.
METHODS: After presenting our two cases of SS, we systematically reviewed articles published in MEDILINE/PubMed, Cochrane Library, and Web of Science.
RESULTS: The meta-analysis included 54 reported cases and 2 of our own cases. Our results showed that all cases achieved symptom improvement with appropriate treatment for GER. Notably, 19 of the 56 cases exhibited anatomical anomalies, such as hiatal hernia and malrotation. Significantly more patients with than without anatomical anomalies required surgery (p < 0.001). However, 23 of the 29 patients without anatomical anomalies (79%) achieved symptom improvement without surgery. Patients who did not undergo surgery had a median (interquartile range) duration to symptom resolution of 1 (1-1) month.
CONCLUSIONS: The primary care providers should keep SS in the differential diagnosis of patients presenting with abnormal posturing and no apparent neuromuscular disorders. Fundoplication may be effective especially for patients with anatomical anomalies or those whose symptoms do not improve after more than 1 month with nonsurgical treatment.
摘要：
目标：Sandifer综合征（SS），结合了胃食管反流（GER）和神经或精神疾病，是一种罕见的疾病，通常需要很长时间才能诊断。我们旨在系统地审查有关SS的现有论文。
方法：在介绍了我们的两例SS后，我们系统地回顾了发表在MEDILINE/PubMed上的文章，科克伦图书馆,和WebofScience。
结果：荟萃分析包括54例报告病例和2例我们自己的病例。我们的结果表明，通过适当的GER治疗，所有病例均实现了症状改善。值得注意的是,56例中有19例表现为解剖异常，如食管裂孔疝和旋转不良。与没有解剖异常的患者相比，更多的患者需要手术治疗（p<0.001）。然而,在没有解剖异常的29例患者中，有23例（79％）在没有手术的情况下症状得到了改善。未接受手术的患者至症状缓解的中位持续时间（四分位距）为1（1-1）个月。
结论：初级保健提供者应在姿势异常且无明显神经肌肉疾病的患者的鉴别诊断中保留SS。胃底折叠术可能是有效的，特别是对于解剖异常的患者或那些在非手术治疗超过1个月后症状没有改善的患者。
方法：在介绍了我们的两例SS后，我们系统地回顾了发表在MEDILINE/PubMed上的文章，科克伦图书馆,和WebofScience。
结果：荟萃分析包括54例报告病例和2例我们自己的病例。我们的结果表明，通过适当的GER治疗，所有病例均实现了症状改善。值得注意的是,56例中有19例表现为解剖异常，如食管裂孔疝和旋转不良。与没有解剖异常的患者相比，更多的患者需要手术治疗（p<0.001）。然而,在没有解剖异常的29例患者中，有23例（79％）在没有手术的情况下症状得到了改善。未接受手术的患者至症状缓解的中位持续时间（四分位距）为1（1-1）个月。
结论：初级保健提供者应在姿势异常且无明显神经肌肉疾病的患者的鉴别诊断中保留SS。胃底折叠术可能是有效的，特别是对于解剖异常的患者或那些在非手术治疗超过1个月后症状没有改善的患者。
