Symptoms of spina bifida

Spina bifida can cause a wide range of symptoms that can be grouped into three general categories.

These are:

• mobility symptoms problems affecting movement
• bladder and bowel problems problems controlling urination and bowel movements
• problems related to Hydrocephalus (excess fluid on the brain)

The severity of the symptoms can vary considerably, largely depending on where on the spine the opening occurs.

Spina bifida causing a gap higher up the back is more likely to cause paralysis of the lower limbs and mobility difficulties compared with gaps in the middle or at the base of the back. A baby is more likely to have cognitive symptoms if he or she develops hydrocephalus.

Mobility symptoms

The brain controls all the muscles in the body with the nerves that run through the spinal cord. Any damage to the nerves can result in problems controlling the muscles.

Most children with spina bifida will experience some degree of weakness or paralysis in their lower limbs. If a child with spina bifida has weakness, they may need to use ankle supports or crutches to help with their mobility. In cases of more severe paralysis, the child will require a wheelchair.

Paralysis can also cause other, associated problems. For example, as the muscles in the legs are not being used regularly, they can become severely weakened.

As the muscles support the bones, this weakness can affect bone development. This can result in dislocated or deformed joints, bone fractures, misshapen bones and an abnormal curvature of the spine ( scoliosis ).

Bowel and bladder symptoms

As well as controlling your limbs, the nerves that run through your spinal cord also control your bowel and bladder. They help to control the muscles that keep urine in the bladder and stools in the bowel (sphincter muscles).

Many people with spina bifida have limited or no control over their sphincter muscles, and experience urinary and bowel incontinence. The bladder muscle may be very tight or twitchy and only store a little urine, which can mean there is a constant slow dribble of urine from the bladder. If left untreated, this can lead to problems such as recurrent urinary tract infections (UTIs) and kidney damage.

Bowel incontinence may involve periods of constipation followed by episodes of diarrhoea or soiling, due to stools overflowing from the bowel.

There can also be problems with sexual function.

Problems related to hydrocephalus

Some babies with spina bifida will have or will develop hydrocephalus, which can damage the brain and cause further problems.

Most people with spina bifida will have normal intelligence, although many will have learning difficulties, such as:

• a short attention span
• difficulty solving problems
• difficulty reading
• difficulty understanding some spoken language particularly fast conversations between a group of people
• difficulty organising activities or making detailed plans

They may also have difficulty with visual and physical co-ordination for example, tasks such as tying shoelaces or fastening buttons.

Some babies with spina bifida have a problem called a type 2 Arnold-Chiari malformation (where lower parts of the brain are pushed downwards towards the spinal cord), which is linked to hydrocephalus.

These can cause additional symptoms soon after birth, such as irritability, seizures (fits), drowsiness, vomiting and poor feeding. .