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TABLE 2

Systemic Effects of Myelomeningocele

SystemEffects
Neurologic  
    Central Hydrocephalus, Chiari II malformation, dysgenesis of the corpus callosum 
    Cranial nerves Vision, strabismus, hearing, speech, stridor, swallow 
    Spinal Tethered cord, progressive loss of motor and sensory function 
    Motor Paraplegia, upper extremity hypotonia 
    Sensory Loss of sensation and proprioception 
    Cognitive Cognitive deficits including learning disabilities, executive function disorders, attention-deficit/hyperactivity disorder 
 Lower cranium nerve dysfunction 
Vision  
    Acuity Visual acuity problems, rarely severe 
    Alignment Strabismus, oculomotor disorders 
Oromotor Oromotor dysfunction, swallowing disorder 
Respiratory  
    Central Central ventilatory disorder, apnea, sleep apnea, hypoventilation 
    Pulmonary Aspiration, restrictive and obstructive lung disease, pneumonia 
 Stridor 
Gastrointestinal  
    Swallow Swallowing dysfunction; oral, pharyngeal 
    Neurogenic bowel Constipation, soiling, accidents 
Urologic  
    Neurogenic bladder Bladder atonia/dystonia, increased bladder pressure, leakage/incontinence, reflux, renal failure 
    UTI Bacterial colonization, acute/chronic UTIs 
Genital  
    Insensitivity Lack of sexual sensation, erectile dysfunction, and retrograde ejaculation in males 
    Infertility Early pubertal onset and increased risk of NTD in infants of women with NTD 
Orthopedic  
    Spinal Scoliosis/kyphosis 
    Extremities Decreased mobility, hip dislocation, clubbed feet, osteopenia, fracture, linear growth abnormalities 
Growth  
    Stature Short stature resulting from limb-length disorders and precocious puberty in females 
    Weight Overweight and obesity 
Psychology  
    Anxiety/depression Increased anxiety and depression 
    Behavior Social isolation, anxiety, depression, immaturity, risk-taking behavior, at increased risk for abuse 
Social  
    Inclusion Social isolation, limited friendship, physical and transportation barriers 
    Employment Limited work experience, physical/society barriers, loss of health coverage or benefits 
SystemEffects
Neurologic  
    Central Hydrocephalus, Chiari II malformation, dysgenesis of the corpus callosum 
    Cranial nerves Vision, strabismus, hearing, speech, stridor, swallow 
    Spinal Tethered cord, progressive loss of motor and sensory function 
    Motor Paraplegia, upper extremity hypotonia 
    Sensory Loss of sensation and proprioception 
    Cognitive Cognitive deficits including learning disabilities, executive function disorders, attention-deficit/hyperactivity disorder 
 Lower cranium nerve dysfunction 
Vision  
    Acuity Visual acuity problems, rarely severe 
    Alignment Strabismus, oculomotor disorders 
Oromotor Oromotor dysfunction, swallowing disorder 
Respiratory  
    Central Central ventilatory disorder, apnea, sleep apnea, hypoventilation 
    Pulmonary Aspiration, restrictive and obstructive lung disease, pneumonia 
 Stridor 
Gastrointestinal  
    Swallow Swallowing dysfunction; oral, pharyngeal 
    Neurogenic bowel Constipation, soiling, accidents 
Urologic  
    Neurogenic bladder Bladder atonia/dystonia, increased bladder pressure, leakage/incontinence, reflux, renal failure 
    UTI Bacterial colonization, acute/chronic UTIs 
Genital  
    Insensitivity Lack of sexual sensation, erectile dysfunction, and retrograde ejaculation in males 
    Infertility Early pubertal onset and increased risk of NTD in infants of women with NTD 
Orthopedic  
    Spinal Scoliosis/kyphosis 
    Extremities Decreased mobility, hip dislocation, clubbed feet, osteopenia, fracture, linear growth abnormalities 
Growth  
    Stature Short stature resulting from limb-length disorders and precocious puberty in females 
    Weight Overweight and obesity 
Psychology  
    Anxiety/depression Increased anxiety and depression 
    Behavior Social isolation, anxiety, depression, immaturity, risk-taking behavior, at increased risk for abuse 
Social  
    Inclusion Social isolation, limited friendship, physical and transportation barriers 
    Employment Limited work experience, physical/society barriers, loss of health coverage or benefits 

Myelomeningocele is the most serious and complex NTD and affects multiple body systems; the severity of these effects is related to the type and location of the NTD and the extent of neuronal injury.

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