Spina Bifida
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1
Neural tube does not fully close during development, usually closes by 4 weeks from conception
spina bifida
2
(mildest form)-not visible, many don't know they have it
- typically goes undiagnosed as there are often no symptoms
- may see signs on skin such as mark or hair
- typically goes undiagnosed as there are often no symptoms
- may see signs on skin such as mark or hair
spina bifida occulta
3
vertebrae do not fully close, meningies protrude in a sac
- bladderowel difficulties
- rare
- bladderowel difficulties
- rare
meningocele
4
(most severe form)-spinal cord is exposed
- nerve pain/damage
- spinal cord damage
- paralysis
- can be life threatening
- nerve pain/damage
- spinal cord damage
- paralysis
- can be life threatening
myelomeningocele
5
what is the etiology of spina bifida
The cause is not fully known and thought to be multifaceted
Genetic, family history of neural tube defects
Environmental risk factors
Nutritional risk factors
- folate deficiency
- some medications
Genetic, family history of neural tube defects
Environmental risk factors
Nutritional risk factors
- folate deficiency
- some medications
6
what has greatly decreased the prevalence of spina bifida
adding folic acid into prenatal vitamins
7
how do you diagnose spina bifida
Most often detected in utero during 20-week anatomy scan
- Ultrasound
- Alpha-fetoprotein
- Amniocentesis
- Fetal MRI
Can go unnoticed until birth
- Ultrasound
- Alpha-fetoprotein
- Amniocentesis
- Fetal MRI
Can go unnoticed until birth
8
what is the medical intervention for occulta
only normal pediatric and adult health care needed
9
what is the medical intervention for meningocele
- may require more advanced care
- bowel and bladder support often needed
- bowel and bladder support often needed
10
what is the medical intervention for myelomeningocele
Life threatening, requires team of specialists
Surgery in utero or soon after birth
Lifelong medical follow ups
May require therapies due to paralysis
Surgery in utero or soon after birth
Lifelong medical follow ups
May require therapies due to paralysis
11
how does occulta impact occupational performance
minimal to none
12
how does meningocele impact occupational performance
bowel and bladder management
13
how does myelomeningocele impact occupational performance
largest impact
paralysis
bowel and bladder management
paralysis
bowel and bladder management
14
what are the precautions for spina bifida
surgical precautions
non-surgical precautions
fall risk
decrease sensation
non-surgical precautions
fall risk
decrease sensation
15
what are the contraindications for spina bifida
shunt
16
what are the considerations for spina bifida
bowel and bladder management
nerve damage
contact sports
nerve damage
contact sports
17
what are some other common neural tube defects
anencephaly
encephalocele
iniencephaly
encephalocele
iniencephaly
18
- most common after spina bifida
- brain and skull do not fully develop
- usually stillborn or die shortly after birth
- brain and skull do not fully develop
- usually stillborn or die shortly after birth
anencephaly
19
- rare
- neural tube does not fully close near the brain, causing an opening in the skull
- wide range of severity similar to spina bifida
- neural tube does not fully close near the brain, causing an opening in the skull
- wide range of severity similar to spina bifida
encephalocele
20
- rare
- exceptionally distorted spine, often resulting in infant not having a neck
- severe deformities
- usually die shortly afterbirth
- exceptionally distorted spine, often resulting in infant not having a neck
- severe deformities
- usually die shortly afterbirth
iniencephaly
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