Myeloningocele: epidemiology and its relationship with other neurological complications
Keywords:
Myeloningocele, Chiari malformation, functional level, neurologic complicationsAbstract
Introduction: Myeloningocele (MMC) represents the most severe form of spinal dysrhaphism. It is often associated to neurological complications such as Chiari malformation, tethered spinal cord, hydrocephalus, etc. The objective of this study is to describe the MMC population epidemiological characteristics, to relate the associated neurological complications, and to establish whether there exists, a relation with the functional level.
Materials and methods: 43 patients treated by the MMC group in the Hospital de Niños “Victor J. Vilela” (Victor J. Vilela Childrens´s Hospital) in the city of Rosario, Argentina. Determining the functional level the MMC classification according to functional level IREP modified by CANEO was used.
Results: 55,8% boys and 44,2 girls. Medullary level 65% lumbar. 81,39% was open and 18,61% closed. MMC average time of repair was 28 hrs. 90,69% presented hydrocephalus. 65,11% showed Chiari Malformation Type II. 55% of patients presented tethered spinal cord (58% lumbar level). According to CANEO classification, 47,65% corresponded to Level 3. Other neurologic complications detected were: 7% syringomyelia 2% hydromyelila and hemagioma. It was detected that 7% of the patients had a family history of MMC.
Discussion: In more that 50% of cases, the most frequent localization of MMC is dorsolumbar or lumbar. It is more common in females, but in our study groups were alike with a slightly larger tendency in males. Chiari Malformation is found in 80% of the patients as well as hydrocephalus. Thetered spinal cord and syringomyelia are complications that can be associated to MMC. Knowledge of MMC population´s characteristics of each region is fundamental for the appropriate treatment of patients, and interdisciplinary therapy approach to provide the patient an improved quality of life.
Author Biography
Melina Longoni
APREPA.
References
78(1):35-42.
2. Goldschmidt EL, Tello AM. Prevención de los defectos del cierre del tubo neural. Revista del Hospital de niños de Buenos Aires. 2000;42:238-244.
3. Aicardi J. Diseases of the nervous system in childhood. 2nd Edition. Cambridge: Mac Keith Press, 1998.
4. Bear MF, Connors BW, Paradiso MA. Estructura del sistema nervioso. En Neurociencia explorando el cerebro. Barcelona: Masson, 1998.
5. Aristizábal A. Mielomeningocele y osteomielitis.
Reporte de un caso. CIMEL 2006;11(2):94-99.
6. Fejerman FA. Neurología pediátrica. 2.ª Ed. Buenos Aires: Panamericana, 1997.
7. Office of Communications and Public Liaison National Institute of Neurological Disorders and Stroke National Institutes of Health Bethesda, MD 20892. Disponible
en: http://espanol.ninds.nih.gov/trastornos/
malformaciones_de_chiari.htm
8. Dias M, Mc Lone D. Hydrocephalus in the child with dysraphism. Neurosurgical Clinics of North America 4: pp 715-726. Nueva York.
9. Swaiman KF. Pediatric neurology. Second Edition. St. Louis, Missouri: Mosby-Year Book, Inc.; 1994.
10. Nickel RE and Magenis RE. Neural tube defects and deletions of 22q11. Am J Med Genet 1996;66:25-27.
11. La genética y la espina bífida Ed. por Elizabeth C. Melvin, MS, CGC, Asesora genética certificada del Centro Médico de la Universidad Duke, Centro de Genética Humana.
12. Children with Spina Bifida. A Parent’s Guide. Marlene Lutkenhoff, editor. 1999.
13. Bethesda, MD. Woodbine House. Living Your Own Life: A Handbook for Teenagers by Young People and Adults with Chronic Illness or Disabilities. Minneapolis, MN. PACER Center, Inc.
How to Cite
Downloads
Downloads
Published
Issue
Section
