Long Term Effects of Chronic Neurological Dysfunction

Question 1

What are the proposed aetiologies of spina bifida

Answer 1

• Potatoe bright,
• Vitamin deficiencies (folate),
• Maternal factor,
• Zinc deficiency,
• High sound intensity,
• Viral infection,
• Alcohol,
• Mineral deficiency,
• Medication

Question 2

What are the neurological consequences of severe spina bifida?

Answer 2

Paralysis, loss of sensation and reflexes distal to the abnormality

Question 3

What are the neonatal consequences of severe spina bifida

Answer 3

• High risk of meningitis in open lesions.

- Hydrocephalus because of interruption of the circulation of CSF

Question 4

What is a potential complication of shunts?

Answer 4

They can become infected or blocked

Question 5

What are the associated conditions of spina bifida?

Answer 5

Renal anomalies (most life threatening), sphincter function, intellectual impairments, and musculoskeletal (paralytic deformities of feet, scolisosis).

Question 6

What occurs if there is a spinal lesion at S3-5

Answer 6

All muscle activity and bowel/bladder function may be normal! The lower down the lesion is, then the less severe.

Question 7

What occurs if there is a spinal lesion at L4?

Answer 7

It will affect the medial knee flexors or ankle dorsiflexors. It can cause a flexed knee gait so patient relies on intact quads. Paralysed calf muscle results in excess ankle dorsiflextion. Muscle fatigue as energy inefficient gait and knee pain (joint degeneration)

Question 8

What are the challenges to mobility as an adult with an L4 lesions

Answer 8

There is an increasing height and weight as the child grows but muscle strength doesn’t change so can cause more muscle fatigue and worsen knee pain. However an L4 lesion doesn’t preclude driving

Question 9

What is a charcot joint?

Answer 9

Progressive degeneration of a weight bearing joint.

Question 10

What can occur in an neurogenic bladder (tends to be spinal lesions (L2-4)

Answer 10

Urinary incontinence. Incomplete bladder emptying leads to back pressure on ureters and eventual renal parenchymal damage and failure. So spinal injury patients have kidneys scanned at least every 2 years.

Question 11

What are the common sites of MS?

Answer 11

Optic nerve, periventricular region, brainstem and cerebellar connections, cervical spine and posterior columns.