Q: What is Spina Bifida?
A: This term is used to describe a series of birth defects affecting the spinal cord and central nervous system. Spina bifida occurs when the vertebrae surrounding the spine are unable to fuse together or form properly, which could leave the spinal cord and surrounding tissues exposed. There are varying levels of severity which could lead to symptoms ranging from a slight dimpling in the back to total paralysis of the lower limbs.
Q: Who Discovered Spina Bifida?
A: Although there is evidence suggesting that spina bifida has been described for thousands of years, it was officially named by a Dutch professor and surgeon named Nicholas Tulp. He gave spina bifida its name as well as the first official description of this disease, sometime during his lifetime between 1593 and 1674. In 1761, spina bifida was linked with lower limb deformities and hydrocephalus by an Italian scientist named Giovanni Battista Morgagni.
Q: Are There Different Types of Spina Bifida?
A: There are three main types of spina bifida, including occulta, meningocele, and myelomeningocele. The least severe type, spina bifida occulta, can be mild enough that there are no discernable symptoms. Meningocele causes minor disabilities and occurs when the protective tissues surrounding the spine are pushed out of a small spinal opening like a sac. The most severe type of spina bifida, myelomeningocele, can lead to nerve damage and other more serious complications.
Q: Who is at Risk for Spina Bifida?
A: According to the American Pregnancy Association, every pregnant woman is potentially at risk for this type of birth defect, as 95% of neural tube defects occur in women who have no prior family history. Some risk factors have been linked to spina bifida, however, including diabetes, obesity, use of certain anti-seizure medications, high temperatures in early pregnancy, or folic acid deficiency. Women who have already had a baby with spina bifida are more at risk.
Q: How Often Does Spina Bifida Occur?
A: Spina bifida is nowhere near as common as it used to be, because more pregnant women now take folic acid supplements to help reduce their chances of having a baby suffering from this disorder. The exact rate will vary depending on countries, but the rate is estimated near 8 out of every 10,000 live births by some experts. Others estimate it as closer to 1 in 1000, with few of these being severe.
Q: What Causes Spina Bifida?
A: There is no singular cause for spina bifida that has been pinpointed yet. At the moment, several risk factors have been associated with an increased risk in fetal development of this disorder. A lack of folic acid in a pregnant woman’s diet can make it difficult for her fetus to grow properly. Obesity, diabetes, previous pregnancy with neural tube defects and certain anti-seizure medications have also been linked to the development of spina bifida.
Q: How Common is Spina Bifida?
A: It’s difficult for experts to estimate just how common spina bifida is in the mildest form, because so many adults carry it without even being aware. As more women are now taking folic acid supplements during pregnancy, the rates of severe spina bifida have now dropped quite dramatically. The rates will also vary by country, but it is now estimated that 8 out of every 10,000 live births will carry this defect worldwide.
Q: What Can Be Done to Reduce the Risk of Spina Bifida?
A: At the moment, there is no way to guarantee the prevention of spina bifida. However, there are a few ways to reduce the risk. Taking folic acid supplements is one way, with experts estimating that it’s possible for pregnant women to reduce the risk of spina bifida by 70% if they take 400 micrograms per day. Staying in shape may also cut the risk, because obesity and diabetes have been linked to neural tube defects.
Q: What is Spina Bifida Occulta?
A: The mildest form of spina bifida, occulta may affect up to 40% of all Americans, most of whom will experience no symptoms and will never know that they have this disorder. This simply entails a small opening in one or two vertebrae, with the spinal cord left unaffected. There may be a birthmark, dimpling of the skin, or a small patch of hair on the back where this opening lies.
Q: How Do You Prevent Spina Bifida?
A: Although there is no surefire way to prevent spina bifida, experts recommend that all pregnant women take 400 micrograms of folic acid per day. This water-soluble B-vitamin has been shown to greatly reduce the risk of developing neural tube defects by helping to grow healthy cells in the developing embryo. Scientists estimate that the risk of spina bifida can be lowered by 70% if women take their daily dose of folic acid throughout their pregnancy.
Q: What Are Signs and Symptoms of Spina Bifida?
A: The symptoms will vary depending on the type of spina bifida, as mild forms carry almost no signs or symptoms at all. Effects can be different for every person. Children with the most severe form of spina bifida may experience hydrocephalus, or fluid on the brain, and need a shunt put in place. Other symptoms include paralysis of the lower limbs, loss of bladder or bowel control, an allergy to latex, and learning disabilities.
Q: How is Spina Bifida Treated?
A: While there is no cure, there are several different treatment options depending on severity. For the most severe cases of myelomeningocele, surgery is usually necessary to close the spinal gap and prevent infection. Prenatal surgery is also an option, to help close this spinal gap before the baby is born. Other treatment options include physical therapy, braces and crutches. Catheters may be put in place to ease bladder problems, and shunts to treat hydrocephalus.
Q: What Are Medications for Spina Bifida?
A: Medication is usually not needed for the mildest forms of spina bifida, but for more severe cases there are several options depending on symptoms. Antibiotics are administered to help prevent infections such as meningitis. Folic acid is given as a supplement to pregnant women to help prevent the incidence of spina bifida to begin with. Oxybutynin or other similar medications can also be given to children with spina bifida who suffer from incontinence.
Q: What Are Complications of Spina Bifida?
A: Most people with spina bifida have a normal level of intelligence and freedom of movement. Yet in severe cases, there may be complications. These include paralysis, loss of sensation in the lower limbs, and a blockage of cerebrospinal fluid, or hydrocephalus, leading to possible brain damage or retardation. An infection such as meningitis can occur in newborns, which can be life-threatening. Other complications include learning disabilities, depression, and skin problems later in life.
Q: What Does Spina Bifida Look Like?
A: Due to the wide range of variation in the types of spina bifida, there are many different possibilities. In the case of children with spina bifida occulta, there may be a small birthmark or patch of hair on the back. Others will have a small sac made of up tissues protruding from the skin. In the case of severe spina bifida, there could be a visible opening in the back, with nerves and tissue exposed.
Q: What Conditions Are Associated with Spina Bifida?
A: There are several conditions that have been linked to spina bifida. Paralysis of the lower limbs results from damage to the spinal cord, and hydrocephalus, or fluid on the brain, occurs in a high percentage of children with spina bifida. Bowel and bladder problems are also common symptoms, which can be treated with diet or a catheter. Other conditions that may occur include depression, learning disabilities, obesity, scoliosis, seizures, tendonitis, and an allergy to latex.
Q: Can Spina Bifida Be Detected Before Birth?
A: There are certain prenatal tests which can detect spina bifida while the fetus is still in the womb. These are usually carried out in the second trimester of pregnancy. The first test administered is a blood test which checks for high levels of alpha fetoprotein. While this doesn’t guarantee neural tube defects, if these are found, then amniocentesis or ultrasounds can also be used to confirm whether or not the fetus may have spina bifida.
Q: What is the Long-term Outlook for Children with Spina Bifida?
A: The outlook will depend on the severity and type of spina bifida that each child carries. For those who have the least serious form, occulta, there are virtually no symptoms and this will not affect longevity. A study published in 2001 estimates that 75% of children who carry the most severe form of spina bifida will live until their early adult years at the very least. Ongoing supportive care is needed, however.
Q: How Do You Test for Spina Bifida?
A: Pregnant women can elect to take a blood test in their second trimester which tests for spina bifida as well as other conditions such as Down syndrome. If high levels of alpha fetoprotein are found, then further tests including amniocentesis can be carried out. However, high protein levels will not necessarily mean that a neural tube defect is present. This can also be tested for after birth with the use of X-rays, CT-scans, and ultrasounds.
References:
1. http://www.americanpregnancy.org/birthdefects/spinabifida.html
2. http://www.emedicinehealth.com/spina_bifida
3. http://rarediseases.about.com/od/rarediseasess/a/spinabifida.htm
4. http://www.nlm.nih.gov/medlineplus/spinabifida.html
5. http://www.medicinenet.com/spina_bifida_and_anencephaly/index.htm
