Effect of dystonic movements on oesophageal peristalsis in Sandifer's syndrome 1313

Fig 2 Three channel oesophageal manometry showing an increase in amplitude and velocity ofperistalsis when head rotated and tilted towards the left shoulder. (a) Shows two representative swallows with 5 ml boluses while head in the midline. Peristaltic waves are broad based and oflow amplitude. (b) Shows two representative swallows with 5 ml boluses while head rotated to the left. Amplitude of peristaltic waves is increased especially in middle channel. Distances y and y' are less than x and x' showing that peristaltic waves are travelling more rapidly in mid to lower oesophagus. oesophageal motility remains unclear. Manometric studies in future patients may help to explain the abnormal movements seen in this rare and intriguing disorder.