What is the difference between myelomeningocele and meningomyelocele

Therefore, a child born with these types of spina bifida who has not undergone prenatal surgery will have surgery to close the defect and minimize the risk of infection or further trauma within the first few days of life.

Some children with myelomeningocele and closed neural tube defects will need surgery to improve the alignment of their feet, legs, or spine. Children with myelomeningocele usually have hydrocephalus and may require surgery to help drain fluid in the brain, such as the placement of a shunt or ETV.

Multiple surgeries may be required to replace the shunt, which may become clogged, infected, or disconnected. Some individuals with myelomeningocele or closed neural tube defects require assistive devices for mobility such as braces, walkers, crutches, or wheelchairs.

The location of the defect on the spine often determines the type of assistive devices needed. Children with a defect high on the spine will have little movement of the legs and will use a wheelchair for mobility.

Children with a defect lower on the spine usually have more strength in the legs. They may be able to walk independently, or they may use crutches, leg braces, walkers, and wheelchairs depending on the activity. Children with myelomeningocele usually have some degree of delayed mobility, so they are referred to physical therapists early on to maximize their strength and function. Treatment for bladder and bowel dysfunction typically begins soon after birth.

Children with myelomeningocele and some closed neural tube defects have damage to the lowest spinal nerves which control typical bowel and bladder function. Some children may be able to urinate typically, but most will need to drain their bladders with a catheter or thin tube times a day to remain dry in between and to prevent kidney damage.

Kidneys are monitored closely so that medications or surgeries can be performed to prevent renal failure. To prevent bowel accidents many people with myelomeningocele and closed neural type defects will use rectal medications or large volume enemas to have planned bowel movements. Close follow-up with a spina bifida specialty clinic is recommended to develop a safe bowel and bladder program.

Treatment for progressive tethering of the spinal cord called tethered cord syndrome can be treated with surgery to help prevent further neurological deterioration. Genetic studies. In one study supported by NINDS , scientists are looking at the hereditary basis of neural tube defects and hope to find the genetic factors that make some children more likely to have a neural tube defect.

These researchers are also studying gene expression during the process of normal neural tube closure, which will provide information on the human nervous system during development. Findings may lead to ways to prevent these disorders. In addition, NINDS-supported scientists are working to identify, characterize, and evaluate genes involved in neural tube defects.

The goal is to understand the genetics of neural tube closure and to develop information that will lead to improved clinical care, treatment, and genetic counseling. Other scientists are studying genetic risk factors for spina bifida, especially those that reduce the effectiveness of folic acid in preventing spina bifida. This study will shed light on how folic acid prevents spina bifida and may lead to improved forms of folate supplements.

Developmental studies. NINDS supports and conducts a wide range of basic research studies to understand how the brain and nervous system develop. These studies contribute to a greater understanding of neural tube defects such as spina bifida and offer hope for new ways to treat and potentially prevent these disorders as well as other birth defects. Because fetal surgery has shown promise, NINDS-funded researchers are also developing new methods, such as stem cell patches and tissue engineering, to add to the prenatal repair of spinal defects.

Other NIH research efforts. Myelomeningocele can be seen after the child is born. A neurologic exam may show that the child has loss of nerve-related functions below the defect. For example, watching how the infant responds to pinpricks at various locations may tell where the baby can feel the sensations.

The health care provider may suggest genetic counseling. Intrauterine surgery to close the defect before the baby is born may reduce the risk of some later complications. After your baby is born, surgery to repair the defect is most often suggested within the first few days of life. Before surgery, the infant must be handled carefully to reduce damage to the exposed spinal cord. This may include:. Children who also have hydrocephalus may need a ventriculoperitoneal shunt placed.

This will help drain the extra fluid from the ventricles in the brain to the peritoneal cavity in the abdomen. Antibiotics may be used to treat or prevent infections such as meningitis or urinary tract infections.

Most children will need lifelong treatment for problems that result from damage to the spinal cord and spinal nerves. Visiting nurses, social services, support groups, and local agencies can provide emotional support and assist with the care of a child with a myelomeningocele who has significant problems or limitations.

Taking part in a spina bifida support group may be helpful. A myelomeningocele can most often be surgically corrected, but the affected nerves may still not function normally. The higher the location of the defect on the baby's back, the more nerves will be affected.

With early treatment, length of life is not severely affected. Kidney problems due to poor drainage of urine are the most common cause of death. Most children will have normal intelligence. However, because of the risk of hydrocephalus and meningitis, more of these children will have learning problems and seizure disorders.

New problems within the spinal cord can develop later in life, especially after the child begins growing rapidly during puberty. This can lead to more loss of function as well as orthopedic problems such as scoliosis, foot or ankle deformities, dislocated hips, and joint tightness or contractures. Folic acid supplements may help reduce the risk of neural tube defects such as myelomeningocele. It is recommended that any woman considering becoming pregnant take 0. Pregnant women with high risk need higher dosage.

It is important to remember that folic acid deficiencies must be corrected before becoming pregnant, because the defects develop very early. Women who plan to become pregnant may be screened to determine the amount of folic acid in their blood. American College of Obstetricians and Gynecologists. ACOG Committee opinion no.

Obstet Gynecol. Other kinds of spina bifida include: Spina bifida occulta : This is a gap in the bones in the spine but the spinal cord and meninges do not push through it. They are in their normal place inside the spinal canal, and there's no opening on the baby's back. Meningocele: This is when a sac that contains spinal fluid pushes through the gap in the spine. The spinal cord is in its normal place in the spinal canal. The skin over the meningocele often is open.

How Does a Myelomeningocele Happen? What Causes a Myelomeningocele? A woman also might be more likely to have a baby with a myelomeningocele if she: takes certain seizure medicines during pregnancy already has had a baby with spina bifida has diabetes How Is Myelomeningocele Diagnosed?

A myelomeningocele that's not diagnosed during pregnancy is seen when the baby is born. How Is Myelomeningocele Treated? After delivery, a baby born with a myelomeningocele will need: surgery to close the skin over the myelomeningocele usually within 3 days testing for Chiari malformation and hydrocephalus with an ultrasound, CT scan, or MRI regular checks of head size to see if hydrocephalus develops regular checks of movements to see how the spinal cord and nerves are working Other medical care will depend on a child's needs.

Treatments can include: a shunt for hydrocephalus the shunt drains the spinal fluid into the belly so it doesn't build up leg braces to help walking a wheelchair a tube called a catheter to help empty the bladder surgery on the spine or legs surgery for Chiari malformations physical therapy PT occupational therapy OT special help at school Some myelomeningoceles found before birth are treated with surgery while the baby is still in the womb.

What Can Parents Do? To help your child stay as healthy as possible: Take your child to all medical appointments. Follow all treatment recommendations, such as giving medicines and going to PT and OT. Call your doctor right away if your child has: new weakness worsening bladder or bowel control headaches vomiting tiredness back pain or pain at the myelomeningocele site neck pain, trouble swallowing, or voice changes Having a child with a serious medical condition can feel overwhelming for any family.