What Is Meningomyelocele in Children?
Meningomyelocele is a type of spina
bifida. Spina bifida is a birth defect in which the spinal canal and the
backbone don’t close before the baby is born. This type of birth defect is also
called a neural tube defect.
The spinal cord and the meninges (the
tissue that covers the spinal cord) may actually protrude through the child’s
back. In some cases that skin covers the spinal cord and meninges, it may also
stick through the skin.
Spina bifida most commonly occurs in
- spina bifida occulta
Of these three, meningomyelocele is
the most common.
What Are the Symptoms of Meningomyelocele?
A baby with meningomyelocele is born
with the spinal cord exposed. A sac on the baby’s mid to lower back may cover
the exposed spinal cord.
The exact symptoms and their severity
depend on your child’s particular case. Meningomyelocele is often very severe,
because the spinal cord has usually not developed properly.
Abnormalities in the spinal cord often
cause problems in leg, bladder, and bowel function. Some
children might lose complete control of their bladder or bowel. Their legs may
be partially or completely paralyzed or lack sensation. In other children, these
body parts and their functions are only mildly affected.
Other possible symptoms include:
- orthopedic deformities
- hydrocephalus (buildup of fluid in the skull
that leads to swelling of the brain)
- Chiari II malformation (structural defects in
the part of the brain that controls balance)
Because the spinal cord is exposed, a
child with meningomyelocele is at risk of developing bacterial meningitis.
What Causes Meningomyelocele?
Doctors don’t know exactly why this
condition occurs. It’s possible that a lack of folic acid before and during
early pregnancy impairs the development of the spinal cord. The
condition may also be partly genetic. In many cases, however, there is no
How Is Meningomyelocele Diagnosed?
This condition is usually diagnosed
during the second trimester of pregnancy, when women can have a blood test
called the quadruple screen. The test can screen for several conditions
including meningomyelocele, Down syndrome, and other congenital diseases of the
baby. Most women who carry a baby with neural tube defects have elevated levels
of maternal alpha fetoprotein (AFP).
If the screen test is positive,
further tests such a pregnancy ultrasound or amniocentesis can confirm the
How Is Meningomyelocele Treated?
This condition is typically diagnosed
during early pregnancy. Some women opt to terminate the pregnancy.
If you choose not to do so, your baby
will most likely need surgery after birth. Prompt surgery can help protect your
child from infections such as meningitis. Your doctor might prescribe
antibiotics as an additional measure in preventing these infections.
If your child has hydrocephalus,
sometimes called water on the brain, they may need to have a shunt inserted.
The shunt can drain extra liquid from around the brain and reduce pressure.
Your child may not develop bladder
control. If this is the case, they might need a catheter to help drain the
Because of the effect this condition
can have on your child’s lower limbs, they might need to wear braces. Braces
are orthopedic devices that support the legs or main part of the body.
In most cases, your child’s treatment
will be lifelong. They’ll need to see a doctor regularly to assess any
developing problems. They may also need to use a wheelchair for life.
What Is the Long-Term Outlook?
Modern treatments have lengthened the
life span for people with spina bifida. The University of Northern Carolina
estimates 90 percent
of people with this condition live to adulthood. Treatments for spina bifida
are continuing to improve.
Babies with spina bifida often require
many surgeries to treat physical abnormalities they’re born with. Babies are
most likely to die as a result of a birth defect, or because of a complication
from a surgery to fix a birth defect in the first few years after diagnosis.
How Can I Prevent Meningomyelocele?
Spina bifida and other neural tube
defects are believed to be related to low levels of folic acid. It’s important
to take folic acid supplements during pregnancy. Folic acid is a B vitamin that
is important in the development of red blood cells and is important for good
health in general, especially during pregnancy. You should take a folic acid
supplement before you become pregnant.