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 depends on the type and severity of the
disorder. Generally, children with the mild form need no treatment, although
some may require surgery as they grow.
The key priorities for treating myelomeningocele are to prevent infection
from developing through the exposed nerves and tissue of the defect on the
spine, and to protect the exposed nerves and structures from additional trauma.
Typically, a child born with spina bifida will have surgery to close the defect
and prevent infection or further trauma within the first few days of life.
Doctors have recently begun performing fetal surgery for treatment of
myelomeningocele. Fetal surgery—which is performed in utero (within the
uterus)—involves opening the mother's abdomen and uterus and sewing shut the
opening over the developing baby's spinal cord. Some doctors believe the earlier
the defect is corrected, the better the outcome is for the baby. Although the
procedure cannot restore lost neurological function, it may prevent additional
loss from occurring. However, the surgery is considered experimental and there
are risks to the fetus as well as to the mother.
The major risks to the fetus are those that might occur if the surgery
stimulates premature delivery such as organ immaturity, brain hemorrhage, and
death. Risks to the mother include infection, blood loss leading to the need for
transfusion,
gestational diabetes, and weight gain due to bed rest.
Still, the benefits of fetal surgery are promising, and include less exposure
of the vulnerable spinal nerve tissue and bones to the intrauterine environment,
in particular the amniotic fluid, which
is considered toxic. As an added benefit, doctors have discovered that the
procedure affects the way the brain develops in the uterus, allowing certain
complications—such as Chiari II with associated hydrocephalus—to correct
themselves, thus, reducing or, in some cases, eliminating the need for surgery
to implant a shunt.
Many children with myelomeningocele develop a condition
called progressive tethering, or tethered cord syndrome, in which their spinal
cords become fastened to an immovable structure—such as overlying membranes and
vertebrae—causing the spinal cord to become abnormally stretched and the
vertebrae elongated with growth and movement. This condition can cause loss of
muscle function to the legs, bowel, and bladder. Early surgery on the spinal
cord may allow the child to regain a normal level of functioning and prevent
further neurological deterioration.
Some children will need subsequent surgeries to manage problems with the
feet, hips, or spine. Individuals with hydrocephalus generally will require
additional surgeries to replace the shunt, which can be outgrown or become
clogged.
Some individuals with spina bifida require assistive
devices such as braces, crutches, or wheelchairs. The location of the
malformation on the spine often indicates the type of assistive devices needed.
Children with a defect high on the spine and more extensive paralysis will often
require a wheelchair, while those with a defect lower on the spine may be able
to use crutches, bladder catherizations, leg braces, or walkers.
Treatment for paralysis and bladder and bowel problems typically begins soon
after birth, and may include special exercises for the legs and feet to help
prepare the child for walking with braces or crutches when he or she is older.
There are many causes of back pain. Pain in the low back can relate to the bony lumbar spine, discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, muscles of the low back, internal organs of the pelvis and abdomen, and the skin covering the lumbar area.
Down syndrome is a chromosomal disorder that results in the presence of an additional third chromosome 21, also referred to as trisomy 21. Most individuals with Down syndrome have widely recognizable physical characteristics. The severity of Down syndrome ranges from mild to severe. Diagnostic testing for Down syndrome include amniocentesis, chorionic villus sampling, and percutaneous umbilical cord sampling. The most common risk factor for Down syndrome is a woman's age.
Hydrocephalus is an abnormal buildup of cerebrospinal fluid (CSF) in the ventricles of the brain. The fluid is often under increased pressure and can compress and damage the brain. Symptoms of hydrocephalus vary with age, progression of the disease, and individual tolerance to the condition. Hydrocephalus is most often treated by surgery in which a shunt system is inserted.
Encephalitis is a brain inflammation that causes sudden fever, vomiting, headache, light sensitivity, stiff neck and back, drowsiness, and irritability. Meningitis is an infection that causes inflammation of the meninges that surround the brain and spinal cord. Symptoms of meningitis include high fever, headache, nausea, vomiting, and stiff neck.
Alcohol intake by a pregnant mother may result in fetal alcohol syndrome (FAS) in her child. A child with FAS may be hyperactive and have a low IQ, a small head, a growth lag, short eye openings, flattened cheekbones, a short nose, a smooth, thin upper lip, shortening of the fourth and fifth fingers, and a heart murmur.
Learning disabilities can cause an individual to have trouble learning and using skills such as reading, listening, writing, reading, speaking, reasoning, and performing mathematics. There is no cure for learning disabilities. Parents and teachers working together to properly diagnose learning disabilities can properly plan a course of education. For some, medication may be appropriate as complimentary treatment.
Birthmarks and other abnormal skin pigmentation is caused by the body's inability to produce enough melanin. Abnormal skin pigmentation can cause conditions such as vitiligo, pigmentation loss, melasma, albinism, port wine stains, macular stains and hemangioma.
Genetic disease is a disorder or condition caused by abnormalities in a person's genome. Types of genetic inheritance include single inheritance (for example, cystic fibrosis, sickle cell anemia, Marfan syndrome, and hemochromatosis), multifactoral inheritance, chromosome abnormalities (for example, Turner syndrome, and Klinefelter syndrome), and mitochondrial inheritance (for example, epilepsy and dementia).
Birth defects have many causes and currently, are the leading cause of death for infants in the first year of life. Some of the causes of birth defects include genetic or chromosome problems. Exposure of the mother to rubella or German measles during pregnancy, or using drugs or alcohol during pregnancy. The treatment for birth defects depends upon the condition of the effected child.
Pregnancy planning is important to help prevent exposure of the mother and fetus to potentially harmful medications and substances during the early days, and throughout the pregnancy. Nutritional planning, prevention of birth defects, conditions such as high blood pressure, heart disease, diabetes, and kidney disease need careful monitoring. Gestational diabetes, preeclampsia, and pregnancy induced hypertension are conditions that may arise during pregnancy. Immunizations, inherited disorders, exercise, air travel, intercourse, and birth control are important factors to consider when planning a pregnancy.
Gestational diabetes is a condition that is first recognized during pregnancy and is characterized by high blood sugar. Approximately 4% of all pregnancies are diagnosed with gestational diabetes. Low blood sugar is prevented by hormones produced by the placenta during a woman's pregnancy. The actions of insulin are stopped by these hormones. Gestational diabetes is the result of the pancreas' s inability to produce enough insulin to overcome the effect of the increase hormones during pregnancy.
Urinary incontinence in children (enuresis) is twice as common in boys as in girls and may occur during the daytime or nighttime. Nighttime urinary incontinence is also called bedwetting and sleepwetting. The cause of nighttime incontinence in children is unknown. Daytime incontinence in children may be caused by an overactive bladder. Though many children overcome urinary incontinence naturally, it may be necessary to treat incontinence with medications, bladder training and moisture alarms, which wake the child when he or she begins to urinate.
Taking prescription medications or over-the-counter drugs or supplements should be discussed with your doctor. There are some medications that have been found to cause no problems in pregnancy, however, medications such as Accutane for acne, should never be taken during pregnancy.
Pregnancy can bring challenges like weight gain, stretch marks, varicose veins, heartburn, constipation, hemorrhoids, problems sleeping, and wondering if it is safe to have sex while pregnant. Learn how to manage and move through these challenges during pregnancy.
There are many syndromes and defects that may cause urine blockage in newborns. Defects in the urinary tract that may cause urine blockage include vesicoureteral reflux, ureteropelvic junction obstruction, bladder outlet obstruction, posterior urethral valves, nerve disease, and ureterocele. Syndromes that may cause urinary blockage include congenital heart defects, esophageal atresia, and prune belly syndrome. Treatment for urine blockage in newborns depends on the cause of the blockage.
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