Neural tube defects

1. Neural tube defects

2. Introduction
• Neural tube defects are a group of
developmental abnormalities where the
neural tube fails to fuse in the spinal cord or
the brain
• Spina bifida is NTD where the lesion occurs in
the spine

3. • between 17 and 30 days
after conception the
neural tube forms in the
embryo and closes
• the neural tube becomes
the spinal cord, spine,
brain, and skull

4. • if the neural tube fails to close properly, it
leaves the developing brain or spinal cord
exposed to the amniotic fluid
1.spina bifida occurs in the lower end of the
neural tube
2.anencephaly occurs in the upper end,affecting
the development of brain, causing
pregnancies miscarriages or infants die very
soon after birth

5. types of spina bifida
• spina bifida occulta
• meningocele
• myelomeningocele
• rachischisis

6. • spina bifida occulta
• mild and most common
• small separation in one or more of the
vertebrae
• no symptoms
• discovered during imaging test of unrelated
reasons

7. • meningocele
• no neural tissue outside the vertbral canal

8. • myelominingocele
• neural tissue and nerve roots may be outside
the vertebral canal

9. • rachischisis
• there is no sac and the neural tissue lies open
on the surface as a flattened plaque

10. risk factors
1.Folate deficiency
2.Family history
3.Medication ex anti seizure valproic acid
4.diabetes
5.obesity
6.Fever in the eary days of pregnancy

11. • Folic acid have a beneficial effect in preventing
the NTD in population of women at risk
• 4mg/day before conception and for the first 3
months of pregnancy is recomended

12. hedrocephalus
• is caused by obstruction to the normal
pathways of flow of CSF in the brain
• hedrocephalus develops in 80% of children
with spina bifida and less likely in lower region

13. symptoms and complications
• the spinal canal remains open or form sac
• muscles weakness and paralysis
• spinal deformities (scoliosis)
• dislocation of the hip
• joints deformities
• abnormal growth
• muscles contractures
• bowel and bladder problems
• hydrocephalus

14. • meningitis
• sleep disordered breathing
• skin wounds due to lack of feeling
• latex allergy

15. • tethered spinal cord (bind to scar after
closing) the spinal cord less able to grow and
cause loss of muscle functions
• chiari malformation brain stem elongated and
positioned lower causing breathing and
swallowing problems

16. managment
• surgery before birth
• surgery after birth
• bowel and bladder managment
• hydrocephalus shunt

17. physical therapy goals
1.development of independent mobility
2.development of physical skills
3.prevention of deformities

18. • assessment for baby
1.record the baby’s resting posture
2.active movements
3.abnormalities or deformities
4.reflexes and muscle group power
5.sensation using firm pinprick
6.assessment start form toes upward

19. • managment for babies
1.passive movement
2.stretches
3.for hip dislocation or spine deformities use
splints
4.position in prone, supine, sitting and standing
to promote normal development milestone
5.opportunity to explore environment and
enhance perception

20. • school age child
1.occupational therapy
2.using wheelchair or sticks or cruches
3.dressing orthoses
4.intermittent catheterization

21. hydrocephalus shunt
• symptoms of shunt problems
1.headache
2.vomiting
3.weakness
4.decreased consiciousness
5.irritability
6.visual problems