Long Term Effects of Chronic Neurological Disability Flashcards
What is the epidemiology surrounding chronic neurological disability?
10 million in UK with neurological disability
1 million in UK disabled by neurological condition
350, 000 require help with ADLs
Neurological conditions are the most common cause of serious disability
How many children have an acquired brain injury?
200, 000
How many people in the UK are carers for people with a neurological condition?
850, 000
Who first described spina bifida?
Nicholas Tulp
What is the incidence of spina bifida?
1-1.5/2000 births
What are some of the proposed causes of spina bifida?
Multi-factorial inheritance
Potato blight
Vitamin, folate, mineral and zinc deficiencies
Maternal fever
Viral infection
Alcohol
Medication e.g. phenytoin, epilim
What is cerebral palsy?
Spectrum of motor disorders affecting posture, movement and coordination
Caused by brain lesion resulting in abnormal development of the CNS
What is the incidence of spina bifida?
2-3 per 1000 live births
When do the neuropores close?
Rostral - 26 days
Caudal - 29 days
What may a sacral dimple indicate?
Spina bifida
What are the consequences of severe spina bifida?
Lower motor neurone lesion leading to paralysis, loss of sensation and reflexes distal to the abnormality
Describe the spectrum of abnormality of spina bifida (mild-severe)
Minor/ not clinically important - spina bifida occulta, sacral dimple
Mild - cord remains in neural canal, herniated meninges and CSF, but not cord
Severe - cord displaced from the neural canal or cord not developed
What are the neonatal consequences of severe spina bifida?
High risk of meningitis in open lesions
Hydrocephalus due to interruption of circulation of CSF
How can spina bifida be detected antenatally?
Ultrasound at 16-18 weeks
Alpha fetoprotein at 16-20 weeks
How would an L4 lesion affect motor response?
No motor function below knee apart from tibialis anterior
Weak glutei