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Many children with spina bifida will have a deformity of the brain called
Chiari II malformation. About one in every three children with spina bifida will
exhibit mild symptoms of Chiari syndrome, usually in the form of feeding and
swallowing problems. About one in twenty children with spina bifida will exhibit
severe symptoms. You should become familiar with the signs and symptoms of
Chiari malformation before your child leaves the hospital:
- hypersensitivity to objects in the mouth (ie lumps in food, toothbrush)
- gagging
- choking
- vomiting
- stridor (high pitched "croupy" sounds)
- tightness and/or weakness of arms
- arching of head backwards
- weak suck when bottle/breast feeding
Children may outgrow the difficulties of choking and swallowing, and
difficulties with eating and drinking may diminish as they grow. Some children
with hypersensitivity in or around the mouth may be helped by an occupational
therapist or a speech language pathologist. A physiotherapist may provide
suggestions for positioning to reduce neck arching and tightness of the arms.
Decompression Surgery
If symptoms persist or are severe, surgery may be required to reduce the
pressure in the brain stem area. One option is the decompression of the
brainstem by removing the back of the cervical vertebrae and the lowest part of
the skull. This serves to unroof the cervical spine, thereby relieving pressure
on the low-lying brainstem. You and your neurosurgeon should discuss the
options.
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