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Spina bifida, literally means split spine, it is characterized by the incomplete development of the brain, spinal
cord, and/or meninges (the protective covering around the brain and spinal cord).
There are four types of spina bifida: occulta, closed neural tube defects, meningocele, and myelomeningocele.
- Occulta is the mildest and most common form in which one or more vertebrae are malformed. The name "occulta," which means
"hidden," indicates that the malformation, or opening in the spine, is covered by a layer of skin. This form of spina bifida
rarely causes disability or symptoms.
- Closed neural tube defects make up the second type of spina bifida. This form consists of a diverse group of spinal defects
in which the spinal cord is marked by a malformation of fat, bone, or membranes. In some patients there are few or no symptoms;
in others the malformation causes incomplete paralysis with urinary and bowel dysfunction.
- In the third type, meningocele, the meninges protrude from the spinal opening, and the malformation may or may not be
covered by a layer of skin. Some patients with meningocele may have few or no symptoms while others may experience symptoms
similar to closed neural tube defects.
- Myelomeningocele, the fourth form, is the most severe and occurs when the spinal cord is exposed through the opening in
the spine, resulting in partial or complete paralysis of the parts of the body below the spinal opening. The paralysis may
be so severe that the affected individual is unable to walk and may have urinary and bowel dysfunction.
The cause of spina bifida seems to still be some what of a mystery. No one knows what disrupts complete closure of the
neural tube, causing a malformation to develop. Scientists suspect genetic, nutritional, and or environmental factors could
play a part. Research seems to indicate that insufficient intake of folic acid, a common B vitamin in the mother’s diet
is a key factor in causing spina bifida and other neural tube defects.
Symptoms
The symptoms of spina bifida are different from person to person and depend on the type. Often, individuals with occulta
have no outward signs of the disorder. Closed neural tube defects are often recognized early in life due to an abnormal tuft
or clump of hair or a small dimple or birthmark on the skin at the site of the spinal malformation.
Meningocele and myelomeningocele generally involve a fluid-filled sac which is visible on the back, protruding from the
spinal cord. In meningocele, the sac may be covered by a thin layer of skin, whereas in most cases of myelomeningocele, there
is no layer of skin covering the sac and a section of spinal cord tissue usually is exposed.
In most cases, spina bifida is diagnosed prenatally. However, in some mild cases it may go unnoticed until after birth.
In very mild cases, in which there are no symptoms, it may never be detected. At present there is no cure for spina bifida.
The nerve tissue that is damaged or lost cannot be repaired or replaced, nor can function be restored to the damaged nerves.
Treatment
The treatment given depends on the type and severity of the disorder. Children with the mild form need no treatment, although
some may require surgery as they grow. . Typically, a child born with myelomeningocele or meningocele spina bifida will have
surgery as a foetus, which is a new treatment or more commonly in the first few hours or days of life. Some children will
need subsequent surgeries to manage problems with the feet, hips, or spine. Some individuals with spina bifida need aids such
as braces, crutches, leg braces, walkers or wheelchairs.
Prevention
It is felt that to help in the prevention of this condition folic acid, may have a part to play as it is an important vitamin
in the development of a healthy foetus. Recent studies have shown that by adding folic acid to their diets, women of childbearing
age significantly reduce the risk of having a child with a neural tube defect, such as spina bifida. Therefore, it is recommended
that all women of childbearing age consume 400 micrograms of folic acid daily. Foods high in folic acid include broccoli,
spinach, egg yolks, and some fruits such as oranges. Many multivitamins contain the recommended dosage of folic acid as well
but read the label to make sure. Women who have a child with spina bifida, have spina bifida themselves, or have already had
a pregnancy affected by any neural tube defect are at greater risk of having a child with spina bifida or another neural tube
defect. These women may require more folic acid 5mg for several months before they become pregnant.
For help, advice and support contact ASBAH, at www.asbah.org or call their help line on 0845 450 7755 open Mon to Fri
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