S H A K E Z ’ LY N C H

SPINA BIFIDA

SPINA BIFIDA

• Spina bifida is a birth defect that involves the incomplete development of the spinal cord or its coverings. The term spina bifida comes from Latin and literally means "split" or "open" spine. Spina bifida occurs at the end of the first month of pregnancy when the two sides of the embryo's spine fail to join together, leaving an open area. In some cases, the spinal cord or other membranes may push through this opening in the back. The condition usually is detected before a baby is born and treated right away.

TYPES OF SPINA BIFIDA

• The causes of spina bifida are largely unknown. Some evidence suggests that genes may play a role, but in most cases there is no familial connection. A high fever during pregnancy may increase a woman's chances of having a baby with spina bifida. Women with epilepsy who have taken the drug valproic acid to control seizures may have an increased risk of having a baby with spina bifida. The two forms of spina bifida are spina bifida occulta and spina bifida manifesta.

SPINA BIFIDA OCCULTA

• is the mildest form of spina bifida. "Occulta" means hidden, meaning that the defect is covered by skin and not open. Most children with this type of condition never have health problems and the spinal cord is often unaffected. Some can have symptoms if the hidden defect is severe enough.

SPINA BIFIDA MANIFESTA

Spina bifida manifesta includes two types of spina bifida:• 1.Meningocele involves the meninges, the membranes

responsible for covering and protecting the brain and spinal cord. If the meninges push through the hole in the vertebrae (the small, ring-like bones that make up the spinal column), the sac is called a meningocele.

• 2.Myelomeningocele is the most severe form of spina bifida. It occurs when the meninges push through the hole in the back, and the spinal cord also pushes though. Most babies who are born with this type of spina bifida also have hydrocephalus, an accumulation of fluid in and around the brain.

SPINA BIFIDA MANIFESTA (CONT’D)

• Because of the abnormal development of and damage to the spinal cord, a child with myelomeningocele typically has some paralysis. The degree of paralysis largely depends on where the opening occurs in the spine. The higher the opening is on the back, the more severe the paralysis tends to be.

EFFECTS OF SPINA BIFIDA

Some of the effects of spina bifida include learning disabilities, hydrocephalus, and depression. There are many factors that determine the severity of these effects. Some of these factors include the size and location of the malformation, whether skin covers the malformation, and which spinal nerves are involved in the malformation. Children with spina bifida often have problems with bowel and bladder control, and some may have attention deficit hyperactivity disorder (ADHD) or other learning difficulties, such as hand-eye coordination problems. The effects of spina bifida can range from minor physical problems to severe physical and mental disabilities. However, it is important to note that most people with spina bifida are of normal intelligence.

DIAGNOSING SPINA BIFIDA

• Expectant parents may be able to find out if a baby has spina bifida by taking certain kinds of prenatal tests. The alpha-fetoprotein (AFP) test, performed between the 16th and 18th weeks of pregnancy, measures how much AFP, which the fetus produces, has passed in the mother's bloodstream. If the amount is high, the test is repeated because in many cases, high AFP readings are false. If the second result is high, other tests will be done to double-check and confirm the diagnosis. Doctors also may use ultrasound to see if a baby has spina bifida; in some cases, the spinal defect can be seen on the ultrasound study. Amniocentesis also can help determine whether a baby has spina bifida. A needle is inserted through the mother's belly and into the uterus to collect fluid that is tested for AFP.

SYMPTOMS OF SPINA BIFIDA

• Babies who are born with spina bifida occulta often have no outward signs or symptoms. The spinal cord does not protrude through the skin, although a patch of hair, a birthmark, or a dimple may be present on the skin over the lower spine. But other forms of the disease have obvious signs. Babies who are born with the meningocele form have a fluid-filled sac visible on the back. The sac is often covered by a thin layer of skin and can be as small as a grape or as large as a grapefruit. Babies with myelomeningocele also have a sac-like mass that bulges from the back, but a layer of skin may not always cover it. In some cases, the nerves of the spinal cord may be exposed. A baby who also has hydrocephalus will have an enlarged head, the result of excess fluid and pressure inside the skull.

CARING FOR A CHILD WITH SPINA BIFIDA

• Parents of children with spina bifida receive support from a medical team that may include several doctors (such as neurosurgeons, urologists, orthopedic surgeons, rehabilitation specialists, and general pediatricians), a nurse practitioner, physical and occupational therapists, and a social worker. The goal is to create a lifestyle for the child and family in which the disability interferes as little as possible with normal everyday activities.

PICTURES

CREDITS

• http://www.uth.tmc.edu/GeneWise/Dysmorph/05.html• http://www.google.com/search?

num=10&hl=en&site=imghp&tbm=isch&source=hp&biw=1366&bih=651&q=spina+bifida&oq=spina+b&gs_l=img.3.0.0l10.1914.2805.0.6510.7.7.0.0.0.0.227.905.2j4j1.7.0...0.0...1ac.1.urVqI5Kcvyw• http://www.webmd.com/parenting/baby/tc/spina-

bifida-topic-overview• http://www.cdc.gov/ncbddd/spinabifida/