Myelomeningocele: Symptoms, Diagnosis, Treatment

Overview

Myelomeningocele refers to a severe kind of spinal bifida in which the meninges and the bones of the spinal column are not formed correctly. It is also called open spina bifida, spinal bifida aperta, and meningomyelocele. As a birth defect, the condition usually happens during early pregnancy. In the embryo’s development process, neural plate cells fold to form a neural tube, which develops into the brain and spinal cord afterward. However, if there appears a problem with the closure of the neural tube, myelomeningocele may develop.

Typically, the condition will manifest itself as a fluid-filled sac on a baby’s back area. A baby with myelomeningocele may experience muscle weakness, sensation loss, bowel and bladder dysfunction etc. And they may develop conditions such as hydrocephalus, Chiari Malformation and so on. Once the condition is diagnosed, the baby should receive immediate treatment.

In the United States, spina bifida, as the most common birth defect, affects around 1 in every 1,400 to 1,500 newborns. Myelomeningocele, as the most severe form of spina bifida, accounts for about 75% of all cases. Also, children of Hispanic background are at a highest risk of developing the condition.  

Causes

At present, the exact reasons for myelomeningocele remain unknown. But researchers have found a series of factors that may lead to the situation, which may include the following:

  • Maternal deficiency of folic acid
  • Exposure to viruses
  • Exposure to radiation
  • Genetic factors
  • Maternal diabetes
  • Obesity
  • Elevated body temperature

According to experts, the disease may be a result of combined factors, which means that there is no single cause of myelomeningocele.

Symptoms

Besides the visible fluid-filled sac on the baby’s back area, other neurological symptoms may arise along with myelomeningocele because the spinal cord is usually impaired, and the brain is also affected.

Common signs and symptoms may include the following:

  • Weakness in the leg
  • Paralysis in severe cases
  • Loss of sensation of the legs and feet
  • Bowel and bladder incontinence
  • Chiari II malformation
  • Hydrocephalus
  • Orthopedic deformities
  • Bacterial meningitis if the spinal cord is exposed

Depending on the different situation, the exact symptoms of a baby with myelomeningocele may vary.

Diagnosis

Getting an early diagnosis plays a crucial role in treating meningomyelocele. In often cases, the condition is detected during the second trimester of pregnancy. The pregnant mother needs to have a blood test named the quadruple screen to see if her baby has meningomyelocele, Down syndrome, and other congenital diseases. Or else, when the pregnant mother goes through the maternal serum alpha-fetoprotein (MSAFP) test, the doctor may check if the alpha-fetoprotein is at a normal level in the mother’s blood.

If the test result shows abnormal conditions, the doctor will order further testing such as ultrasound, which can provide detailed images of internal structures. Thus, the doctor can make a definite diagnosis.

In some cases, the disease may not be recognized until birth. Since myelomeningocele is visible in the back area, the doctor usually can immediately diagnose the situation.

Treatment

Surgery serves as the primary treatment of choice for myelomeningocele. The surgery can either be done in the utero before the baby’s born or can be done after the baby’s born.

Performing the surgery in utero carries very high risk, for both the mother and the baby. Also, the surgery can not be performed in all cases. But the results of the surgical procedure usually are good.

A newborn with myelomeningocele should receive immediate treatment so that infections such as meningitis can be prevented. Antibiotics may also be prescribed in this case to fight against other infections. The surgery mainly aims at closing the spinal cord and the back by using a surgical microscope and fine instruments.

After the surgery, the doctor may order other imaging tests for the baby to rule out other possible abnormalities. However, surgery can not cure the condition completely. Children with myelomeningocele need to be monitored on a regular basis in prevention of other complications.

Keywords: myelomeningocele.

Related Posts:

What are Types of Spinal Bifida?

What is Myelomeningocele in Spinal Bifida?

What are Spinal Bifida Complications in Adults?

How is Spinal Bifida Surgery like?

How is Spinal Bifida and Hydrocephalus Related?

What is Chiari Malformation and What Cause It?

* The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.