Spina Bifida: Difference between revisions
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== Etiology/Causes == | == Etiology/Causes == | ||
Pathology: | Pathology: | ||
*Neural groove develops to form the neural tube around day 20 after conception. In normal development the upper end is supposed to close at day 25 and the lower end is supposed to close at day 27. Three opportunities could cause abnormal closure of the neural tube. If the hyaluronic acid matrix or actin microfilaments have abnormalities early on the neural tube will not close. If an overgrowth occurs over the caudal end the neural tube will not close, but this occurs later in development. The last chance occurs when the glycoproteins that typically hold the cells together during closure fail to adhere the tube together the tube will not properly close. (path 837) <br> | *Neural groove develops to form the neural tube around day 20 after conception. In normal development the upper end is supposed to close at day 25 and the lower end is supposed to close at day 27. Three opportunities could cause abnormal closure of the neural tube. If the hyaluronic acid matrix or actin microfilaments have abnormalities early on the neural tube will not close. If an overgrowth occurs over the caudal end the neural tube will not close, but this occurs later in development. The last chance occurs when the glycoproteins that typically hold the cells together during closure fail to adhere the tube together the tube will not properly close. (path 837) <br> | ||
There is no exact reason known for the cause of Spina Bifida, but there are a variety of environmental and gentic factors that may be potential risk factors (mayo clinic). | |||
Mother’s nutrition: <br> | |||
*Folic acid- less than 400 µg of folic acid per day- (neuro, spina bifida web) | *Folic acid- less than 400 µg of folic acid per day- (neuro, spina bifida web) | ||
*Increase of: Vitamin A, valproic acid, solvents, lead herbicides, glycol ether, clomiphene, carbamazepine, aminopterin, alcohol- neural tube defects in general (pathology 837) | *Increase of: Vitamin A, valproic acid, solvents, lead herbicides, glycol ether, clomiphene, carbamazepine, aminopterin, alcohol- neural tube defects in general (pathology 837) | ||
Genetic: | |||
*1.6%-3.3% increase if have one child with spina bifida, will have another (path 837) | *1.6%-3.3% increase if have one child with spina bifida, will have another (path 837) | ||
== Systemic Involvement == | == Systemic Involvement == | ||
Revision as of 23:09, 2 April 2012
Welcome to PT 635 Pathophysiology of Complex Patient Problems This is a wiki created by and for the students in the School of Physical Therapy at Bellarmine University in Louisville KY. Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!
Original Editors -Ally O'Bryan & Stephanie Smith from Bellarmine University's Pathophysiology of Complex Patient Problems project.
Lead Editors - Your name will be added here if you are a lead editor on this page. Read more.
Definition/Description[edit | edit source]
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Prevalence[edit | edit source]
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Characteristics/Clinical Presentation[edit | edit source]
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Associated Co-morbidities[edit | edit source]
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Medications[edit | edit source]
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Diagnostic Tests/Lab Tests/Lab Values[edit | edit source]
- Alpha-fetoprotein blood test when 16-18 weeks pregnant
- Ultra-sound of the spine
- Maternal amneocentesis- amniotic fluid taken during pregnancy
- After birth: X-ray, MRI, CT scan
- Meningocele and myelomeningocele are visible on exam (path 840)
- Meningocele: protruding sac is transilluminated
- Myelomeningocele: no light shines through the protruding sac
Etiology/Causes[edit | edit source]
Pathology:
- Neural groove develops to form the neural tube around day 20 after conception. In normal development the upper end is supposed to close at day 25 and the lower end is supposed to close at day 27. Three opportunities could cause abnormal closure of the neural tube. If the hyaluronic acid matrix or actin microfilaments have abnormalities early on the neural tube will not close. If an overgrowth occurs over the caudal end the neural tube will not close, but this occurs later in development. The last chance occurs when the glycoproteins that typically hold the cells together during closure fail to adhere the tube together the tube will not properly close. (path 837)
There is no exact reason known for the cause of Spina Bifida, but there are a variety of environmental and gentic factors that may be potential risk factors (mayo clinic).
Mother’s nutrition:
- Folic acid- less than 400 µg of folic acid per day- (neuro, spina bifida web)
- Increase of: Vitamin A, valproic acid, solvents, lead herbicides, glycol ether, clomiphene, carbamazepine, aminopterin, alcohol- neural tube defects in general (pathology 837)
Genetic:
- 1.6%-3.3% increase if have one child with spina bifida, will have another (path 837)
Systemic Involvement[edit | edit source]
Occulta and Meningocele: no neurological dysfunction typically present
Myelomeningocele: permanent neurological deficits present (all path 837) (Mayo clinic- http://www.mayoclinic.com/print/spina-bifida/DS00417/DSECTION=all&METHOD=print)
- Muscle Weakness
- Bowel and Bladder Problems
- Seizures
Medical Management (current best evidence)[edit | edit source]
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Physical Therapy Management (current best evidence)[edit | edit source]
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Alternative/Holistic Management (current best evidence)[edit | edit source]
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Differential Diagnosis[edit | edit source]
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Case Reports/ Case Studies[edit | edit source]
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Resources
[edit | edit source]
- Spina Bifida Association: www.spinabifidaassociation.org
- National Institute of Neurological Disorders and Stroke: disorders/spina_bifida/spina_bifida.htm
- March of Dimes: www.marchofdimes.com/
Recent Related Research (from Pubmed)[edit | edit source]
<div class="researchbox"><rss>http://eutils.ncbi.nlm.nih.gov/entrez/eutils/erss.cgi?rss_guid=1DK1DQN9MQ-BetaSMf4UXFRb4jr9x3AcL3or9IZjEyz170KERb%7Ccharset=UTF-8%7Cshort%7Cmax=10</rss></div>
References[edit | edit source]
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