Diagnostic Dilemma


A 2 month old girl born of non consanguineous marriage presented with hydrocephalus and meningomyelocele diagnosed since birth and excessive crying for 4-5 days. The child had 2 episodes of seizures in last 15 days. On examination, she had wide bulging anterior fontanelle with sun-setting sign and decerebrate posturing with lower lumbosacral meningomyelocele, spastic paraparesis and absent lower limb refluxes.

Should the child undergo any intervention_? How should next pregnancy be handled_?
Expert Opinion :
The parents were counseled about prognosis. They opted for no intervention. The child died in next 48 hours.
Sometimes, it may be necessary not to intervene if it is just going to prolong the suffering of the child.
Answer Discussion :
neelesh kumar
vp shunt, surgical management of meningomyelocele,
folic acid to be started before conception in next pregnancy

10 years ago
the infant should be ,first treated for CNSinfection and then early surgery. periconceptional Folic Acid must be given to mother in next pregnancy
10 years ago

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