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Childhood gastroesophageal reflux. Neurologic and psychiatric syndromes mimicked

P F Bray, J J Herbst, D G Johnson

    JAMA
    |March 28, 1977
    PubMed

    Insights

    Gastroesophageal reflux (GER) can mimic central nervous system (CNS) disorders in infants and children, leading to delayed diagnosis. Early recognition and treatment of GER are crucial to prevent severe health consequences.

    Area of Science:

    • Pediatric Neurology
    • Gastroenterology

    Background:

    • Gastroesophageal reflux (GER) is common in infants and children.
    • GER can present with symptoms that mimic central nervous system (CNS) disorders.
    • Delayed diagnosis of GER can lead to significant morbidity and mortality.

    Observation:

    • Thirteen pediatric patients with confirmed GER presented with symptoms suggestive of a CNS disorder.
    • Presenting symptoms included dystonia, developmental delay, dysphagia, seizures, and irritability.
    • In some cases, diagnosis and treatment were delayed for several years.

    Findings:

    • GER was frequently misdiagnosed or its significance overlooked in these cases.
    • CNS symptoms were the primary indicators leading to suspicion of GER.
    • Accurate diagnosis of GER was established through clinical presentation and confirmed by diagnostic evaluation.

    Implications:

    • There is a need to consider GER in the differential diagnosis of pediatric CNS symptoms.
    • Timely medical or surgical intervention for GER can lead to dramatic improvements.
    • Missed diagnosis or inadequate treatment of GER poses life-threatening risks.

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