Spina Bifida and seizures

This week we'll start by describing a condition called spina bifida, a birth defect that involves incom-plete develop-ment of the spinal cord or its coverings. The term spina bifida comes from Latin and means "split" or "open" spine. Spina bifida occurs at the end of the first month of pregnancy, when the two sides of the 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. This condition is usually detected and treated before birth.

The causes are largely unknown. Some evidence suggests genes may play a role, but in most cases there is no familial connection. A high fever during pregnancy may increase the risk of spina bifida. Women with epilepsy who have taken valproic acid to control seizures may also be at risk. The two forms are spina occulta and spina bifida manifesta. Spina bifida occulta is the mildest form and most children with this defect never have any health problems. Spinal cords are usually unaffected.

Spina bifida manifesta includes two forms -- meningocele and mylomeningocele. Mylomeningocele is by far the most serious. Most babies born with this condition also have hydrocephalus, an accumulation of fluid in and around the brain.

Mylomeningocele patients typically suffer paralysis, the degree of which largely depends on where the opening occurs. The higher the opening, the more severe the paralysis.

Children with spina bifida often have bowel and bladder control problems. Some may have attention deficit hyperactivity disorder or learning disabilities. Parents usually receive help from a medical team that may include doctors, nurse practitioner, physical and occupational therapists, and social workers. The goal is to create a lifestyle in which the disability interferes as little as possible with everyday activities.

We thank Dr. Michael Alexander of the Nemours Foundation for his invaluable description of spina bifida and his work to improve the quality of life for spina bifida patients.

Paul Rendine is chairman of the Disability Advocates of Delmarva Inc. group. Call him at 410-860-1137 or e-mail him at prendine@1stallied.