Download - myelomeningocoele.docx
-
7/27/2019 myelomeningocoele.docx
1/5
Sacral defect and anterior sacral meningocele: A very rare syndrome characterized by a meningocele
(failure of the backbone to close before birth) in the tailbone area. More detailed information about the
symptoms, causes, andtreatmentsof Sacral defect and anterior sacral meningocele is available below
Myelomeningocele
Abnormal tailbone development Anal anomaly
Enlarged uretur
Uterine abnormality
Chronic constipation
Partial absence of tailbone
Urinary incontinence
Myelomeningocele
MedlinePlus Topics
Spina Bifida
Images
Spina bifida
Spina bifida (degrees of severity)
Read More
Central nervous systemCerebral palsy
Dislocation
Folate deficiency
Hydrocephalus
MeningitisMuscle function loss
Numbness and tinglingSyringomyelia
Urinary incontinence
Patient Instructions
http://www.wrongdiagnosis.com/s/sacral_defect_and_anterior_sacral_meningocele/symptoms.htmhttp://www.wrongdiagnosis.com/s/sacral_defect_and_anterior_sacral_meningocele/symptoms.htmhttp://www.wrongdiagnosis.com/s/sacral_defect_and_anterior_sacral_meningocele/treatments.htmhttp://www.wrongdiagnosis.com/s/sacral_defect_and_anterior_sacral_meningocele/treatments.htmhttp://www.wrongdiagnosis.com/s/sacral_defect_and_anterior_sacral_meningocele/treatments.htmhttp://www.wrongdiagnosis.com/sym/constipation.htmhttp://www.wrongdiagnosis.com/sym/constipation.htmhttp://www.wrongdiagnosis.com/sym/urinary_incontinence.htmhttp://www.wrongdiagnosis.com/sym/urinary_incontinence.htmhttp://www.nlm.nih.gov/medlineplus/spinabifida.htmlhttp://www.nlm.nih.gov/medlineplus/spinabifida.htmlhttp://www.nlm.nih.gov/medlineplus/ency/imagepages/19086.htmhttp://www.nlm.nih.gov/medlineplus/ency/imagepages/19086.htmhttp://www.nlm.nih.gov/medlineplus/ency/imagepages/19087.htmhttp://www.nlm.nih.gov/medlineplus/ency/imagepages/19087.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/002311.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/002311.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/000716.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/000716.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/000014.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/000014.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/000354.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/000354.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/001571.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/001571.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/000680.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/000680.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003190.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003190.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003206.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003206.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/001398.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/001398.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003142.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003142.htmhttp://www.nlm.nih.gov/medlineplus/ency/imagepages/19087.htmhttp://www.nlm.nih.gov/medlineplus/ency/imagepages/19086.htmhttp://www.nlm.nih.gov/medlineplus/ency/imagepages/19087.htmhttp://www.nlm.nih.gov/medlineplus/ency/imagepages/19086.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003142.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/001398.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003206.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003190.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/000680.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/001571.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/000354.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/000014.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/000716.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/002311.htmhttp://www.nlm.nih.gov/medlineplus/ency/imagepages/19087.htmhttp://www.nlm.nih.gov/medlineplus/ency/imagepages/19086.htmhttp://www.nlm.nih.gov/medlineplus/spinabifida.htmlhttp://www.wrongdiagnosis.com/sym/urinary_incontinence.htmhttp://www.wrongdiagnosis.com/sym/constipation.htmhttp://www.wrongdiagnosis.com/s/sacral_defect_and_anterior_sacral_meningocele/treatments.htmhttp://www.wrongdiagnosis.com/s/sacral_defect_and_anterior_sacral_meningocele/symptoms.htm -
7/27/2019 myelomeningocoele.docx
2/5
Ventriculoperitoneal shunt - discharge
Myelomeningocele is a birth defect in which the backbone and spinal canal do not close beforebirth. The condition is a type of spina bifida.
Causes
Normally, during the first month of a pregnancy, the two sides of the spine (or backbone) jointogether to cover the spinal cord, spinal nerves and meninges (the tissues covering the spinal
cord). Spina bifida refers to any birth defect involving incomplete closure of the spine.
Myelomeningocele is the most common type of spina bifida. It is a neural tube defect in which
the bones of the spine do not completely form, resulting in an incomplete spinal canal. This
causes the spinal cord and meninges (the tissues covering the spinal cord) to stick out of the
child's back.
Myelomeningocele may affect as many as 1 out of every 800 infants.
The rest of myelomeningocele cases are most commonly:
Spina bifida occulta, a condition in which the bones of the spine do not close but thespinal cord and meninges remain in place and skin usually covers the defect
Meningoceles, a condition where the tissue covering the spinal cord sticks out of thespinal defect but the spinal cord remains in place.
Other congenital disorders or birth defects may also be present in a child withmyelomeningocele. Hydrocephalus may affect as many as 90% of children with
myelomeningocele. Other disorders of the spinal cord or musculoskeletal system may be seen,including syringomyelia and hip dislocation.
The cause of myelomeningocele is unknown. However, low levels of folic acid in a woman's
body before and during early pregnancy is thought to play a part in this type of birth defect. Thevitamin folic acid (or folate) is important for brain and spinal cord development.
Also, if a child is born with myelomeningocele, future children in that family have a higher riskthan the general population. However, in many cases, there is no family connection.
Some theorize that a virus make play a role, since there is a higher rate of this condition in
children born in the early winter months. Research also indicates possible environmental factorssuch as radiation.
Symptoms
A newborn may have a sac sticking out of the mid to lower back. The doctor cannot see through
the sac when shining a light behind it. Symptoms include:
http://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000149.htmhttp://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000149.htmhttp://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000149.htm -
7/27/2019 myelomeningocoele.docx
3/5
Loss of bladder or bowel control Partial or complete lack of sensation Partial or complete paralysis of the legs Weakness of the hips, legs, or feet of a newborn
Other symptoms may include:
Abnormal feet or legs, such asclubfoot Build up of fluid inside the skull (hydrocephalus) Hair at the back part of the pelvis called the sacral area Dimpling of the sacral area
Exams and Tests
Prenatal screening can help diagnose this condition. During the second trimester, pregnantwomen can have a blood test called thequadruple screen. This test screens for
myelomeningocele, Down syndrome, and other congenital diseases in the baby. Most womencarrying a baby with spina bifida will have a higher-than-normal levels of a protein calledmaternal alpha fetoprotein (AFP).
If the quadruple screen test is positive, further testing is needed to confirm the diagnosis. Suchtests may include:
Pregnancy ultrasound Amniocentesis
Myelomeningocele can be seen after the child is born. A neurologic examination may show that
the child has loss of nerve-related functions below the defect. For example, watching how theinfant responds to pinpricks at various locations may reveal where he or she can feel the
sensations.
Tests done on the baby after birth may include x-rays, ultrasound, CT, or MRI of the spinal area.
Treatment
Genetic counseling may be recommended. In some cases where severe defect is detected early in
the pregnancy, a therapeutic abortion may be considered.
After birth,surgery to repair the defectis usually recommended at an early age. Before surgery,the infant must be handled carefully to reduce damage to the exposed spinal cord. This may
include special care and positioning, protective devices, and changes in the methods of handling,feeding, and bathing.
Children who also have hydrocephalus may need aventricular peritoneal shuntplaced. This willhelp drain the extra fluid.
http://www.nlm.nih.gov/medlineplus/ency/article/001228.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/001228.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/001228.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/007311.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/007311.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/007311.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003020.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003020.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003020.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003019.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003019.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003019.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003019.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003020.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/007311.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/001228.htm -
7/27/2019 myelomeningocoele.docx
4/5
Antibiotics may be used to treat or prevent infections such as meningitis or urinary tract
infections.
Most children will require lifelong treatment for problems that result from damage to the spinal
cord and spinal nerves. This includes:
Gentle downward pressure over the bladder may help drain the bladder. In severe cases,drainage tubes, called catheters, may be needed. Bowel training programs and a high
fiber diet may improve bowel function.
Orthopedic or physical therapy may be needed to treat musculoskeletal symptoms. Bracesmay be needed for muscle and joint problems.
Neurological losses are treated according to the type and severity of function loss.Follow-up examinations generally continue throughout the child's life. These are done to check
the child's developmental level and to treat any intellectual, neurological, or physical problems.
Visiting nurses, social services, support groups, and local agencies can provide emotionalsupport and assist with the care of a child with a myelomeningocele who has significantproblems or limitations.
Support Groups
See:Spina bifida resources
Outlook (Prognosis)
A myelomeningocele can usually be surgically corrected. With treatment, length of life is not
severely affected. Neurological damage is often irreversible.
New problems within the spinal cord can develop later in life, especially after the child begins
growing rapidly during puberty. This can lead to more loss of function as well as orthopedic
problems such as scoliosis, foot or ankle deformities, dislocated hips, and joint tightness orcontractures.
Many patients with myelomeningocele primarily use a wheelchair.
Possible Complications
Difficult delivery with problems resulting from a traumatic birth, including cerebral palsyand decreased oxygen to the brain
Frequent urinary tract infections Hydrocephalus Loss of bowel or bladder control Meningitis Permanent weakness or paralysis of legs
http://www.nlm.nih.gov/medlineplus/ency/article/002184.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/002184.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/002184.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/002184.htm -
7/27/2019 myelomeningocoele.docx
5/5
This list may not be all inclusive.
When to Contact a Medical Professional
Call your health care provider if:
A sac sticks out of the spine of a newborn infant. The child is late in walking or crawling Symptoms of hydrocephalus develop, including bulging soft spot, irritability, extreme
sleepiness, and feeding difficulties
Symptoms of menigitis develop, including fever, stiff neck, irritability, and a high-pitched cry
Prevention
Folic acid supplements may help reduce the risk of neural tube defects such as
myelomeningocele. It is recommended that any woman considering becoming pregnant take 0.4mg of folic acid a day. Pregnant women need 1 mg per day.
It is important to remember that folic acid deficiencies must be corrected before becomingpregnant as the defects develop very early.
Prospective mothers may be screened to determine the amount of folic acid in their blood.
Alternative Names
Spina bifida; Cleft spine