Treatment and Complications of Myelomeningocele

Treatment and Complications

Best results are obtained if the treatment of myelomeningocele is a combined efforts of specialists from several disciplines and includes -

• Neurosurgical
• Urologic
• Orthopedic
• Pediatric surgery
• And Plastic surgery

It also needs social service evaluations. A myelomeningocele identified at birth is covered immediately with a sterile dressing. Antibiotics may be required to prevent meningitis (infection of the meninges) if the cerebrospinal fluid (CSF) is leaking. Neurosurgical repair is usually done within the first 72 hours after birth.

Hydrocephalus (explained earlier) may require special operations surgical procedures (shunt procedures).

Affected children require special care and positioning, protective devices, and changes in the methods of handling, feeding, and bathing. Lifelong care may be required to cope with the impacts of damage to the spinal cord and spinal nerves. Bowel and bladder care are of utmost importance. Drainage tubes, called catheters, bowel training programs and a high fiber diet may be needed.

Physical rehabilitative measures, orthopedic treatments, braces may be required to deal with musculoskeletal symptoms.

Complications

• Difficult delivery with problems resulting from a traumatic birth, including cerebral palsy and decreased oxygen to the brain
• Frequent urinary tract infections
• Hydrocephalus
• Loss of bowel or bladder control
• Meningitis
• Permanent weakness or paralysis of legs

References:

1. Nelson Textbook of Pediatrics. 18^th ed.
2. The Merck Manual
3. Cohen AR, Robinson S: Myelomeningocele and myelocystocele. In Youmans Neurological surgery. Volume 2. 5th edition. Edited by Winn HR. Philadelphia: Saunders; 2003:3215-3228.
4. Aubry MC, Aubry JP, Dommergues M: Sonographic prenatal diagnosis of central nervous system abnormalities.
5. Child Nerv Syst 2003, 19:391-402. Publisher Full Text
6. Boyd PA, Wellesley DG, De Walle HEK, Tenconi R, Garcia-Minaur S, Zandwijken GR, Stoll C, Clementi M: Evaluation of the prenatal diagnosis of neural tube defects by fetal ultrasonographic examination in different centers across Europe. J of Medical Screening 2000, 7:169-174. Publisher Full Text

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