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This case elaborates how a simple 'nudge' of religious tenets-based counselling helps the tobacco addict transgress or tide over such barriers. © BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.We present a case of Sandifer syndrome in a 3-year-old girl who initially presented with a history of recurrent paroxysmal head drops associated with ataxia-like symptoms and recurrent falls sustaining a clavicular fracture on one occasion. She was referred to and seen by the