Spina Bifida: Symptoms and Causes

Overview

• Condition where the spine and spinal cord don't form properly (neural tube defect).
• Neural tube forms early in pregnancy and typically closes by the 28th day after conception.
• In spina bifida, the neural tube doesn't close completely, affecting the spinal cord and spine bones.
• Severity ranges from mild to serious disabilities.
• Treatment often involves surgery, although it may not restore lost function.

Types of Spina Bifida

Spina Bifida Occulta

• Mildest form; most common.
• Small gap in one or more vertebrae.
• Usually asymptomatic, may be found during unrelated imaging tests.

Myelomeningocele

• Most serious form; open spina bifida.
• Spinal canal open along several vertebrae.
• Spinal cord and nerves protrude, forming a sac on the back.
• Symptoms include movement loss in legs, bladder/bowel dysfunction, and infection risk.

Meningocele

• Rare type.
• Sac of spinal fluid bulges, but no nerve involvement.
• Minor functional issues possible.

Symptoms

• Spina Bifida Occulta: Typically asymptomatic; may show skin markings like tufts of hair or dimples.
• Meningocele: Possible bladder/bowel issues.
• Myelomeningocele: Open spinal canal, nerve exposure, movement and bladder/bowel issues, possible hydrocephalus.

Medical Consultation

• Myelomeningocele often diagnosed at birth.
• Requires lifelong specialized care.
• Spina bifida occulta usually needs routine pediatric care.

Causes and Risk Factors

• Unknown cause; involves genetic, nutritional, environmental factors.
• Risk Factors:
  • Low folate levels.
  • Family history of neural tube defects.
  • Use of anti-seizure medications.
  • Poorly controlled diabetes.
  • Obesity.
  • High body temperature.

Complications

• Severity influenced by spine opening size/location and nerve involvement.
• Potential Complications:
  • Mobility issues.
  • Orthopedic complications (scoliosis, clubfoot).
  • Bladder/bowel dysfunction.
  • Hydrocephalus and shunt malfunctions.
  • Chiari malformation type 2.
  • Meningitis.
  • Tethered spinal cord.
  • Sleep-disordered breathing.
  • Skin problems due to reduced sensation.
  • Latex allergy.
  • Other issues: infections, GI conditions, learning disabilities.

Prevention

• Adequate folic acid intake is crucial.
• Recommended:
  • 400 mcg folic acid daily for childbearing age.
  • Eat fortified foods: enriched bread, pasta, rice, cereals.
• Planning Pregnancy:
  • 400-800 mcg folic acid daily.
  • Consider higher doses if at risk or previous history of spina bifida.
  • Incorporate folate-rich foods: beans, citrus, egg yolks, milk, avocados, dark greens.

Important Considerations

• Higher folic acid doses for those with personal/family history of spina bifida or on certain medications.
• Consult healthcare professional before adjusting folic acid intake.