pediatrics
Spina Bifida
Symptoms and Signs of Spina Bifida
Many children with minor defects are asymptomatic. When the spinal cord or lumbosacral nerve roots are involved, as is usual, varying degrees of paralysis and sensory deficits are present below the lesion. Rectal tone is usually decreased. Hydrocephalus may cause minimal symptoms or signs of increased intracranial pressure. Brain stem involvement can be associated with hydrocephalus or syringomyelia. It may cause manifestations such as stridor, swallowing difficulties, and intermittent apnea. Lack of muscle innervation leads to atrophy of the legs. Because paralysis occurs in the fetus, orthopedic problems may be present at birth (eg, Talipes Equinovarus (Clubfoot) and Other Foot Abnormalities , Scheuermann Disease is sometimes present and can hinder surgical closure and prevent the child from lying supine. Paralysis also impairs bladder function, occasionally leading to a neurogenic bladder and, consequently, urinary reflux, which can cause hydronephrosis, frequent urinary tract infections, and, ultimately, kidney damage. 