Meningomyelocele Myelomeningocele

Meningomyelocele is the most common congenital defect of the neural tube. The spinal cord, meninges, and vertebral column are involved due to failure of the neural tube to fuse in early embryogenesis. It causes varying amounts of sensory and motor impairment based on the level of the lesion and accompanying medical problems. Incidence is 0.7 per 1000 live births in the United States. Etiology is considered to be multifactorial, although folic acid deficiency has been associated. Folic acid is currently recommended as a supplement as early as possible during pregnancy. Other neural tube defects are anencephaly, encephalocele, lipomeningocele, spina bifida occulta, sacral agenesis, and meningocele.

Children with meningomyelocele have multiple, complex medical problems due to impairment of nerves at or below the site of the lesion. There is variable impairment of sensory and motor nerves controlling voluntary and autonomic functioning. Associated medical concerns include neurogenic bowel and bladder function, contractures, scoliosis, club feet, hydrocephalus, Chiari II malformation, tethering of the spinal cord, spinal cord syrinx, vesicoureteral reflux, decubitus ulcers, constipation, encopresis, recurrent urinary tract infections, growth failure, latex allergy, gastroesophageal reflux, apnea/stridor syndrome, seizures, partial agenesis of the corpus callosum, strabismus, visual acuity impairment, precocious puberty, and osteoporosis. Individuals also may have cognitive impairments. Mild forms of cognitive impairment may affect visual motor functioning. More severe cognitive impairment has been associated with sparing of verbal skills and a "cocktail party" syndrome, in which the children may be able to carry on superficial social conversations with ease but be unable to comprehend and use specific information provided to them or respond to specific questions.

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