Gastroesophageal reflux disease at any cost: a dangerous paediatric attitude

Infantile spasm (IS) is a specific rare type of seizure seen in an epilepsy syndrome of infancy; it is also known as West syndrome and is characterized by developmental regression and a specific pattern on electroencephalography (EEG) testing called hypsarrhythmia (chaotic brain waves). Gastroesophageal Reflux Disease (GERD) is considered a common clinical problem in every day paediatrics clinical practice. However, GERD diagnosis seems to be overestimated, mainly because such symptoms as crying, regurgitation, feeding refusal, back arching, wheezing, coughing and hoarseness are still considered suggestive for GERD, although they have already been demonstrated to be inaccurate (1), with consequent risk for disease overdiagnosis and inappropriate unnecessary Proton Pump Inhibitors (PPI) prescription. Herein, we report the cases of three patients with classical symptoms referable to IS who were initially misdiagnosed as having GERD.