NEURAL TUBE DEFECTS(Myelodysplasia Dysraphism)

Nural tube defects:-

Embryonic precursor of CNS .

(central nervous system){central nervous system-:brain & spinal cord}.

or

Birth defect of CNS.

  • During early embryogenesis intrauterine life 🙁 3rd -4th week)(28 days)In between close normally.
  • NTDs occur when the neural tube does not close properly. 

. In spina bifida the fital spine coumn do not closed completely.

. in Anencephaly defects in brain development occur.

. The part of head and brain does’t from.

. Patients are blind , death , unconscious ,etc.

. Anencephaly is absence of major portion of the brain ,skall and scalp that occurs during embryonic development .

  • It is the malformation of the spine in which the posterior portion of the lamina of the vertebra fails to closed .
  • 🧠Spina bifida:-(“spina=spine”,”bifida=split”)
  • .Affects vertebrae and spinal cord .
  • .a midline defect of the (bone,skin,spinal column, spinal cord)
  • .common site-lumbar area.
  • .spina bifida is divided into 2 subclasses:-
  • 🧠1.spina bifida occulta (closed):-
  • .no protrusion of meninges.
  • .mildest from(meninges do not herniate through the opening in the spinal canal)
  • .small gap in the spine but the opening cannot be seen in the back.
  • .brain and spinal cord functions are normal and there is no disabilities.
  • . defective closer of the posterior arch and laminae of the vertebra.
  • .it is most frequent and most benign neural tube defect.
  • .dysplasia of the spinal cord is a prominent feature .

.

  • ✍️ Asymptomatic:-
  • .children present with cutaneous lesions over the defect.
  • .as tuft of hair.
  • .nervus.
  • .lipoma.
  • .hemangioma(red birth mark)
  • .dermal sinus.
  • dimple in skin.
  • .intramedullary lipoma
  • ✍️symptomatic:-
  • . children usually present after 6-8 yr. Of age .
  • .progressive deformity of the foot.
  • .changes in micturition pattern.
  • .alteration in the gilt .
  • .trophic ulcers on the toes and feet.
  • * other significant Anomalies of spinal cord :-
  • .syringomyelia.
  • .diastematomyelia.
  • .tethered cord ,etc.
  • .progressive neurological deficits is require surgical correction of the defect .
  • .laminectomy is done and intraspinal lesion is excised.
  • .myelo -ct scan and MRI help to confirm the diagnosis before operation.
  • 🧠 2. spina bifida cystoc (open) .
  • .spinal cord and its covering (menninges protrude through the defect and look like a sac.
  • .it again devided in to 2 types .
  • *.1.meningo cele(meningo +csf)
  • *.2.myelomeningocele (spinal+meninges)
  • 1️⃣1 .meningocele :-
  • .one meninges with csf protrude through defect .
  • .spinal cord not involved so neurological deffect are abset.
  • . Generally found in the lower back.l.e.lumbosacral region ,thoracic region ,skull (cranial meningocele)
  • . symptomatic child (weakness of leg or lack of spincter control)
  • . CFS leakage may present & their is chance of infection or injury.
  • .if the sac is not cover the skin ,it should be protected with sterile moist dressing .
  • .spinal cord and nerve not involved.
  • 2️⃣.2.myelomeningoele /meningo myelocele ( myelo=spinal cord ,and meningoele = menninges )
  • .most common type.
  • .protrusion of spinal cord nerve room and menniges .
  • .neural tissue involvement.
  • . neurological defect present.
  • .depend upon the involvement of nerve (paralies,bladder,/bowelansent ,joint defect).
  • ✍️ Etiology:-{ main cause zink & folic acid }
  • .
  •  The exact causes of neural tube defects are not known.
  •  Genetic
  •  Nutritional Factors
  •  Environmental factors.
  •  Poor intake of folic -acid (also known as folate)  Obese Women
  •  Intake of anti epileptic medications during pregnancy
  • certain syndromes and chromosomal disorders.
  • administration of sodium valproate and folic acid., Antagonists, some anti epileptics, triggering factor. Exposure to chemicals malnutrition zinc snd folic acid help in malnutrition (malnutrition formation of DNA).
  • chromosomal abnormality.
  • triggering drugs.
  • a come b vitamin in the mother diet.
  • ,✍️ Signs and symptoms:-
  • Gastro intestine:- bowel obstruction, constipation ,leaking of stool.
  • muscular:- muscle weakness, stiff muscles, over active reflex.
  • skin:- toff of hair, birth Mark, brown spot on skin or skin cyst.
  • Urinary:-bed wetting , leaking of urine or urinary tract infection
  • ✍️ Prevention:-
  • Folic acid Tekken in supplement from starting at least one month before concepts on and continue through the the first trimester of pregnancy, greatly reduce the risk of spina bifida and other neural tube defect. (400 micrograms MCG of folic acid.
  • .enriched bread,, pasta rice some breakfast cereals.
  • Naturally many foods:-
  • Beans and peas, citrus fruits and juice, egg yolk, milk ,avocads, dark green vegetable, such as broccli and spinach.




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