shakeybrainsurgeon
Contributor
Very odd story.
Spina bifida is a spectrum of diseases caused by improper formation of the neural tube during fetal development. We all start life as a flat embryo and then roll into a tube, from head to tail, as the fetus forms. If the tail end doesn't close completely, the lower spine shows openings ranging from a simple lack of some vertebral bone in an otherwise healthy adult (quite common on incidental lumbar X-ray) to frank myelomeningocele (where the baby is born with an open wound on the back, the spinal cord exposed to the air). It is the latter case, the open meningocele, that people identify as the "spina bifida" children --- they are usually paralyzed or nearly so from birth.
In between the two extremes --- subtle bone defects in a normal person and wheelchair-ridden child with an open spinal cord defect --- are many variations of "dysraphism" or neural tube malformations, including tethered cord, Chiari malformation, diastematomyelia, syringix formation, all too complex to discuss here. These diseases may or may not cause paralysis and, if so, it may not develop until years after birth. This man, if he is indeed spina bifida, must be one of these more complex malformations, since he was normal at birth and didn't develop paralysis until the age of twelve. In fact, the growth spurt of puberty often brings out these malformations. The deformed spinal cord, unable to adapt to the lengthening of the spine as the child grows, begins to fail.
One of the main problems in this population of patients is "bad hydraulics" --- deranged spinal fluid flow through the brain and spinal cord/canal. For example, nearly all myelomeningocele children also have hydrocepahlus, or "water on the brain" and need shunt operations to survive. The deformed spinal cord and brain regions of spina bifida patients also causes buildup of fluid inside the spinal cord itself (hydromyelia), a reversible cause of paralysis that can also be treated by shunting the spinal cord surgically with a plastic catheter.
My point here is this: if this story is true, the answer more likely rests to the pressure shifts in his thoracic spinal canal causing a temporary shunting of accumulated fluid somehwere in his spine. If I drain a swollen spinal cord surgically, the paralysis will resolve immediately and last until the pressure builds up again, which may take days, weeks or months depending on the fluid dynamics inside the spine. Hyberbaric oxygen for such short periods does nothing (true hyperbaric treatment, for wound care, is given for hours at a time, several times per week for extended periods).
This man needs a good going over by a neurosurgeon expert in dysraphism in adults to see why this is happening and if it can be duplicated on a more long-term basis with surgical therapy. Of course, it could all be a hoax, it's hard to know for sure with such stories...
Spina bifida is a spectrum of diseases caused by improper formation of the neural tube during fetal development. We all start life as a flat embryo and then roll into a tube, from head to tail, as the fetus forms. If the tail end doesn't close completely, the lower spine shows openings ranging from a simple lack of some vertebral bone in an otherwise healthy adult (quite common on incidental lumbar X-ray) to frank myelomeningocele (where the baby is born with an open wound on the back, the spinal cord exposed to the air). It is the latter case, the open meningocele, that people identify as the "spina bifida" children --- they are usually paralyzed or nearly so from birth.
In between the two extremes --- subtle bone defects in a normal person and wheelchair-ridden child with an open spinal cord defect --- are many variations of "dysraphism" or neural tube malformations, including tethered cord, Chiari malformation, diastematomyelia, syringix formation, all too complex to discuss here. These diseases may or may not cause paralysis and, if so, it may not develop until years after birth. This man, if he is indeed spina bifida, must be one of these more complex malformations, since he was normal at birth and didn't develop paralysis until the age of twelve. In fact, the growth spurt of puberty often brings out these malformations. The deformed spinal cord, unable to adapt to the lengthening of the spine as the child grows, begins to fail.
One of the main problems in this population of patients is "bad hydraulics" --- deranged spinal fluid flow through the brain and spinal cord/canal. For example, nearly all myelomeningocele children also have hydrocepahlus, or "water on the brain" and need shunt operations to survive. The deformed spinal cord and brain regions of spina bifida patients also causes buildup of fluid inside the spinal cord itself (hydromyelia), a reversible cause of paralysis that can also be treated by shunting the spinal cord surgically with a plastic catheter.
My point here is this: if this story is true, the answer more likely rests to the pressure shifts in his thoracic spinal canal causing a temporary shunting of accumulated fluid somehwere in his spine. If I drain a swollen spinal cord surgically, the paralysis will resolve immediately and last until the pressure builds up again, which may take days, weeks or months depending on the fluid dynamics inside the spine. Hyberbaric oxygen for such short periods does nothing (true hyperbaric treatment, for wound care, is given for hours at a time, several times per week for extended periods).
This man needs a good going over by a neurosurgeon expert in dysraphism in adults to see why this is happening and if it can be duplicated on a more long-term basis with surgical therapy. Of course, it could all be a hoax, it's hard to know for sure with such stories...
