Understanding Spina Bifida and Its Impact

Aug 27, 2024

Lecture Notes: Spina Bifida

Overview

  • Definition: Spina bifida means "split spine" in Latin.
  • Description: A birth defect where the spinal tissue fails to close completely, leaving an opening in the lower back.

Embryonic Development

  • Ectoderm Development: Early fetal development creates a neural tube from the ectoderm.
  • Neural Tube Function: Becomes the spinal cord, brain, and meninges.
  • Defect Formation: Failure of the neural tube to close properly results in spina bifida.

Types of Spina Bifida

1. Myelomeningocele

  • Severity: Most severe type.
  • Characteristics: Spinal cord and meninges protrude through an opening in the vertebrae.
  • Symptoms: Exposure can lead to infections, paralysis, loss of sensation, and deformities.
  • Associated Condition: Often linked to Arnold Chiari II malformation and hydrocephalus.

2. Meningocele

  • Characteristics: Only meninges slip through vertebrae gaps.
  • Symptoms: Less severe, spinal cord not damaged.
  • Prevalence: Least common form.

3. Spina Bifida Occulta

  • Severity: Most common and mildest form.
  • Characteristics: No protrusion of spinal tissue.
  • Detection: Often asymptomatic and discovered later in life.
  • Symptoms: Possible hair, dimple, or birthmark over lesion site.

Causes and Risk Factors

  • Unknown Causes: Exact causes are unknown.
  • Folate Deficiency: Lack of folate (Vitamin B9) increases risk.
  • Preventive Measures: Folic acid in prenatal vitamins and enriched grains.
  • Other Risk Factors: Obesity, poorly controlled diabetes, certain medications.

Diagnosis

  • Myelomeningocele Detection: Elevated alpha fetoprotein (AFP) levels in maternal serum.
  • Additional Tests: Blood tests for HCG, inhibin A, estriol, and ultrasound.
  • Amniocentesis: Direct sampling from amniotic sac for serious cases.

Treatment

  • Prenatal Surgery: Dangerous but possible to close myelomeningocele.
  • Postnatal Surgery: Done soon after birth to reduce infection risks.
  • Additional Interventions: Urinary catheterization, crutches, or wheelchairs due to nerve damage.

Recap

  • Spina Bifida Types:
    • Occulta: Most common, least severe.
    • Meningocele: Least common, mild.
    • Myelomeningocele: Most severe.

Conclusion

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