Trip Answers

Question answered:06/02/07 Warning! this question is over two years old.

The Association for Spina Bifida and Hydrocephalus has produced an information sheet on spina bifida occulta in which it distinguishes between two types of spina bifida occulta and their associated complications:

 

“The term ‘spina bifida occulta’ is, in fact, not one but two separate conditions which have completely different consequences. This leads to confusion when such a diagnosis is used without qualification. For the majority of people with spina bifida occulta, it is a minor fault involving one vertebra in the lower back…

 

For a small number of people with spina bifida occulta the fault is more extensive. Either the split in the spine is bigger, or may involve two or more vertebrae. There may be visible signs on the skin such as a mole or naevus (birthmark), a dimple or sinus (hole), or a patch of hair. If these are positioned above the level of the buttocks and in the midline (centrally) there may well be a significant underlying spina bifida occulta…For people with spina bifida occulta, there may be associated difficulties which may include:
foot deformity, weakness and reduced sensation of the legs, change in hand function, bladder infections and incontinence and bowel problems…"

 

Although we cannot fully answer the question concerning the risk of a patient with SOB suffering no neurological impairment of producing a child with SOB and neurological impairment, the following information from the Association for Spina Bifida and Hydrocephus should be of interest:

 

“For the vast majority of people with the nonsignificant form of spina bifida occulta, there are no known complications and there is no higher risk of having children with spina bifida than there is in the general population. For those with the more complicated spina bifida occulta, there may be neurological problems which may or may not be present at birth and may be progressive.

 

Those with significant spina bifida occulta have a risk, higher than in the general population, of having children with spina bifida which could be cystica or occulta. This risk is between 2% and 4% and is the same risk that those with spina bifida cystica have of passing on the disability.” [1]

 

A second information sheet describing what is spina bifida discusses the two types of spina bifida cystica:

 

“a) Meningocele
In this form, the sac contains tissues which cover the spinal cord (meninges) and cerebrospinal fluid. The fluid bathes and protects the brain and spinal cord. The nerves are not usually damaged and are able to function, therefore there may be little disability present. This is the least common form of spina bifida…

 

b) Myelomeningocele
(meningomyelocele)
Myelomeningocele is the most serious and more common of the two forms of cystic spina bifida. Here the cyst not only contains tissue and cerebro-spinal fluid but also nerves and part of the spinal cord. The spinal cord is damaged or not properly developed. As a result, there is always some paralysis and loss of sensation below the damaged region. The amount of disability depends very much on where the spina bifida is, and the amount of nerve damage involved. Most people with this condition have bowel and bladder problems because of damage to the nerves going to the bowel or bladder from the bottom end of the spinal cord.” [2]

 

For further information, the NLH Q & A Service would suggest contacting the Association for Spina Bifida and Hydrocephus:

 

Association for Spina Bifida and Hydrocephalus
ASBAH HOUSE, 42 Park Road, Peterborough PE1 2UQ
Tel: 01733 555988 Fax: 01733 555985
E-mail: postmaster@asbah.org

 

References
1. Association for Spina Bifida and Hydrocephalus. Spina bifida occulta. (http://www.asbah.org/UserFiles/InfSheet_8-SBO.pdf).
2. Association for Spina Bifida and Hydrocephalus. What is spina bifida? (http://www.asbah.org/UserFiles/InfSheet_1-SB(1).pdf).

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