Moro Reflex during sleep with no stimulus

We are trying to figure out what is going on currently with 10 wk old daughter. We took her to the Children's ER at 8 wks because we think she is having seizures or infantile spasms. Her spasms occur when falling asleep, during sleep, upon waking & randomly times while awake. She had a CT scan, blood work & a short EEG, all fine. We are following up with another Neuro & we received no diagnosis. When she is very tired & not swaddled (sometimes even swaddled) she will have the moro reflex so often in succession for well over 30 minutes that she will continuously wake herself up and cry after each one. When she is swaddled, we still notice her jerk and wake herself that way too. What is odd and scary to us is that once she actually falls asleep she will continue to have the moro reflex every 3-5 minutes the whole time she is asleep, with nothing making noise to startle her & she is completely still and asleep. Sometimes it will just be once, & other times it will be 2-3 in a row, it is always 3-5 minutes apart, then often upon waking she will have the same thing happen. She will be interacting and smiling at us then all of sudden have the reflex & then continue on, sometimes she will cry, but oftentimes she will continue kicking or whatever immediately after. This does NOT seem like the normal moro reflex and she is not a baby that startles that easily. We have a loud household with barking dogs that she can sleep right through. Looking back, she has been having "odd" spasms since we brought her home from the hospital after birth. We are very concerned because many of her spasm are extremely similar to Infantile Spasms, but the EEG came back fine. Hoping to get a longer EEG in a few days to put us a little more at ease.  She has silent acid reflux, but the Dr's did not think it is Sandifer's Syndrome....we are at a loss. Is this normal???

[Shazia Alam, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to obtain a history from you and examine your child, I cannot comment on a formal diagnosis or treatment plan for your symptoms. However, I will try to provide you with some information regarding this matter.

Given the symptoms you have described, seizures are still a possiblity.  Unfortunately, a short EEG may not capture them.

Sandifer's Syndrome  may also still be a possibility.  

Although it is great that you are getting a prolonged EEG, your daughter may also need a inpatient pediatric monitoring unit evaluation, where your daughter would be hooked up continuously to an EEG and would be recorded throughout the stay.  

Hope this information was helpful.  Good luck