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Spina Bifida - Disabled Village Children - Page 185
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Spina Bifida
22CHAPTER
167
WHAT IS IT?
Spina bifida (also called meningocele or myelomeningocele) is a defect
that comes from a problem in the very early development of the unborn
child. It happens when some of the back bones (vertebrae) do not
close over the center tube of nerves (spinal cord). As a result, a soft
unprotected area is left, which may bulge through the skin as a dark bag.
This ‘bag of nerves’ is covered by a very thin layer (membrane) which may
leak liquid from the spinal cord and brain. Nobody knows what causes it.
But 1 of every 250 to 500 babies is born with spina bifida.
Problems that occur with spina bifida
• High risk. Without early
surgery to cover the bag of
nerves, it almost always gets
infected and the child dies
of meningitis.
• Muscle weakness and loss
of feeling. The legs or feet
may be paralyzed and have
little or no feeling.
• Hips. One or both hips may
be dislocated.
• The feet may turn down and in (club feet), or up and out.
• If the defect is relatively high up the back (L1 or above, see
next page), there may be muscle spasms (spasticity) in the
legs and feet (see p. 176).
• Poor urine and bowel control. The child may not feel when
he pees or has a stool. When he gets older he may not
develop control, and will pee or shit without knowing it.
• Big head. ‘Hydrocephalus’, which means
‘water on the brain’, develops in 4 out of 5
children with spina bifida. The liquid that
forms inside the head cannot drain normally
into the spinal cord, so it collects and puts
pressure on the brain and skull bones.
Although the child’s head may look normal
at birth, little by little it becomes swollen
with liquid, like this.
• Brain damage. Without early surgery to lower
the pressure of the liquid in the head (and sometimes even if the
surgery is done), some children become blind, mentally slow, have
seizures (see p. 233), or develop cerebral palsy (see Chapter 9).
• very big head
• big veins
• The eyes may turn
downward because of
pressure in the head.
This ‘setting sun sign’
means danger of
blindness and severe
brain damage.
PROBLEMS THAT MAY OCCUR WHEN THE CHILD IS OLDER:
• Curve
of the
spine (See
Chapter 20.)
• Urinary
infections
and
kidney
damage
(See p. 210.)
• Pressure sores
may form over
the bones,
because the
child cannot
feel. (See
Chapter 24.)
• Foot injuries. Children who
can walk but have no feeling
in their feet may easily
develop sores or injuries. If
neglected, these can lead
to severe infections of the
flesh, bone infection, and
deformities or loss of the feet
(see p. 222).
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