GASTROESOPHAGEAL REFLUX AND ESOPHAGEAL DY SMOTILITY IN NEONATES HAVING EXPERIENCED AN APPARENTLY LIFE-THREATENING EVENT AND PRESENTING WITHVAGAL HYPERREFLECTIVITY

Aim. - The aim of the study was to evaluate the prevalence of gastroes ophageal reflux and abnormalities of esophageal motility in a populati on of neonates referred for apparently life threatening event (ALTE) a nd presenting vagal hyperreflectivity. Population and methods. - The s tudy included 17 infants, who were examined after an ALTE. They were a dmitted at a mean age of 11.7 weeks (range 1-40 weeks). Vagal hyperref lectivity was confirmed in each infant by oculocardiac reflex. Before treatment, 24-hour intraesophageal pH-monitoring and esophageal manome try were performed. Results. - pH-monitoring and esophageal manometry were both normal in only two patients. pH-monitoring showed pathologic al reflux (% of time with pH < 4 more than 4.8%) in 10/17 (59%) patien ts. Manometric studies showed esophageal dysmotility in 12/17 (71%) of patients. Hypertensive lower sphincter was noted in 11/17 (65%) infan ts. Patients with normal manometry were older than patients presenting with esophageal dysmotility) (P < 0.05). Conclusion. - This study sho ws a high frequency of gastroesophageal reflux and esophageal dysmotil ity in infants with vagal hyperreflectivity. Hypertensive lower esopha geal sphincter as well as vagal hyperreflectivity may correspond to dy smaturity of autonomous nervous system and facilitate the occurence of ALTE.