Spinal Cord Injury

Spinal Cord Injury

A spinal cord injury (SCI) is damage to the spinal cord that causes changes in its function, either temporary or permanent. These changes translate into loss of muscle function, sensation, or autonomic function in parts of the body served by the spinal cord below the level of the lesion.

Symptoms

Your ability to control your limbs after spinal cord injury depends on two factors: the place of the injury along your spinal cord and the severity of injury to the spinal cord.

The lowest part of your spinal cord that functions normally after injury is referred to as the neurological level of your injury. The severity of the injury is often called "the completeness" and is classified as either of the following:

·         Complete. If almost all feeling (sensory) and all ability to control movement (motor function) are lost below the spinal cord injury, your injury is called complete.

·         Incomplete. If you have some motor or sensory function below the affected area, your injury is called incomplete. There are varying degrees of incomplete injury.

Emergency signs and symptoms of spinal cord injury after an accident may include:

·         Extreme back pain or pressure in your neck, head or back

·         Weakness, incoordination or paralysis in any part of your body

·         Numbness, tingling or loss of sensation in your hands, fingers, feet or toes

·         Loss of bladder or bowel control

·         Difficulty with balance and walking

·         Impaired breathing after injury

·         An oddly positioned or twisted neck or back

Precautions

·         Don't move the injured person — permanent paralysis and other serious complications may result

·         Call emergency medical assistance number

·         Keep the person still

·         Place heavy towels on both sides of the neck or hold the head and neck to prevent them from moving until emergency care arrives

·         Provide basic first aid, such as stopping any bleeding and making the person comfortable, without moving the head or neck

Causes

Spinal cord injuries result from damage to the vertebrae, ligaments or disks of the spinal column or to the spinal cord itself.

A traumatic spinal cord injury may stem from a sudden, traumatic blow to your spine that fractures, dislocates, crushes, or compresses one or more of your vertebrae. It also may result from a gunshot or knife wound that penetrates and cuts your spinal cord.

Additional damage usually occurs over days or weeks because of bleeding, swelling, inflammation and fluid accumulation in and around your spinal cord.

A nontraumatic spinal cord injury may be caused by arthritis, cancer, inflammation, infections or disk degeneration of the spine.

Common causes of spinal cord injury

·         Motor vehicle accidents

·         Falls

·         Acts of violence.

·         Sports and recreation injuries

·         Alcohol.

·         Diseases.

Treatment

Traumatic spinal cord injuries are emergencies, and the person who's injured may not be able to participate in his or her care in the beginning.

A number of specialists will be involved in stabilizing the condition, including a doctor who specializes in nervous system disorders (neurologist) and a surgeon who specializes in spinal cord injuries and other nervous system problems (neurosurgeon), among others.

The rehabilitation team, which will include a variety of specialists, will be led by a doctor who specializes in spinal cord injury.

If you have a possible spinal cord injury or you accompany someone who's had a spinal cord injury and can't provide the necessary information, here are some things you can do to facilitate care.

Spina bifida

Spina bifida

Spina bifida is a birth defect that happens when a baby's backbone (spine) does not form normally. As a result, the spinal cord and the nerves that branch out of it may be damaged. This defect happens at the end of the first month of pregnancy, when a baby's spine and spinal cord (a bundle of nerves that runs down the center of the spine) are developing.

Sometimes, the defect causes an opening in the back, which is visible. The spinal cord and its coverings sometimes push through this opening. Other times, there is no opening and the defect remains hidden under the skin.

Depending on the severity of the defect and where it is on the spine, symptoms vary. Mild defects may cause few or no problems, while more severe defects can cause serious problems, including weakness, loss of bladder control, or paralysis.

Children with an exposed opening on the back will need surgery to close it.

Causes

Low levels of the vitamin folic acid during pregnancy are linked to spina bifida. Folic acid plays a large role in cell growth and development, as well as tissue formation. Not having enough folic acid in the diet before and during early pregnancy can increase a woman's risk of spina bifida and other neural tube defects.

A high fever during pregnancy may increase a woman's chances of having a baby with spina bifida. Women with epilepsy who have taken the drug valproic acid to control seizures also are at an increased risk of having a baby with spina bifida.

Types

The two forms of spina bifida are spina bifida occulta and spina bifida aperta.

Diagnosis

Expectant parents may be able to find out if a baby has spina bifida by taking certain prenatal tests.

Treatment

Treatment for spina bifida depends on its severity. Because spina bifida can involve many different body systems, like the nervous and skeletal systems, children may need support from a team of medical professionals. This team may include doctors (such as neurosurgeons, urologists, and orthopedic surgeons), physical and occupational therapists, and social workers.

Prevention

Many cases of spina bifida can be prevented if women of childbearing age take 0.4 milligrams (400 micrograms) of folic acid every day before pregnancy and continue to take it throughout the first trimester. Some women may have to take more folic acid, especially if they are taking the medicine valproic acid for epilepsy or depression.Good sources of folic acid include eggs, orange juice, and dark green leafy vegetables. Many multivitamins contain the recommended dose of folic acid, too.

Down syndrome

Down syndrome

Down syndrome is a genetic disorder caused when abnormal cell division results in extra genetic material from chromosome 21. This genetic disorder, which varies in severity, causes lifelong intellectual disability and developmental delays, and in some people it causes health problems.

Down syndrome is the most common genetic chromosomal disorder and cause of learning disabilities in children.

Better understanding of Down syndrome and early interventions can greatly increase the quality of life for children and adults with this disorder and help them live fulfilling lives.

Symptoms

Each person with Down syndrome is an individual — intellectual and developmental problems range from mild to moderate, and some people are healthy while others have severe health problems such as serious heart defects.

Children with Down syndrome have a distinct facial appearance. Though not all children with Down syndrome have the same features, some of the more common features are:

·         Flattened facial features

·         Small head

·         Short neck

·         Protruding tongue

·         Upward slanting eyes, unusual for the child's ethnic group

·         Unusually shaped or small ears

·         Poor muscle tone

·         Broad, short hands with a single crease in the palm

·         Relatively short fingers and small hands and feet

·         Excessive flexibility

·         Tiny white spots on the colored part (iris) of the eye called Brushfield spots

·         Short height

Infants with Down syndrome may be average size, but typically they grow slowly and remain shorter than other children the same age. In general, developmental milestones, such as sitting and crawling, occur at about twice the age of children without impairment.

Causes

Human cells normally contain 23 pairs of chromosomes. One chromosome in each pair comes from your father, the other from your mother.

Down syndrome results when abnormal cell division involving chromosome 21 occurs. These cell division abnormalities result in extra genetic material from chromosome 21, which is responsible for the characteristic features and developmental problems of Down syndrome. Any one of three genetic variations can cause Down syndrome:

·         Trisomy 21

·         Mosaic Down syndrome.

·         Translocation Down syndrome.

There are no known behavioral or environmental factors that cause Down syndrome

Some parents have a greater risk of having a baby with Down syndrome. Risk factors include:

·         Advancing maternal age

·         Having had one child with Down syndrome

·         Being carriers of the genetic translocation for Down syndrome.