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Suggest Treatment For Spina Bifida Occulta In A Child

Posted on Thu, 11 Feb 2016

Question: Our 6 year old son is still in nappies day and night. he doesn't know when he needs a pee or a poo and doesn't realise when he has done the toilet either. he is the youngest of 6 children and we haven't had this problem with any of his brothers and sisters. he doesn't have a problem with sitting on the toilet, doesn't get constipated. the educational physiologist says that it isn't behavioural, it is a medical issue.

Answered by Dr. Richa Agarwal (20 minutes later)

Brief Answer:
Need more information.

Detailed Answer:
Hello dear,
Thanks for trusting hcm about your child health care.
I have gone through your history and understand your concerns very well.
But before giving my opinion I would like to ask more questions to you.
Please answer those questions so I could able to give you a better opinion.
Since birth he is unable to do so?
His other milestone normal and on time?
Any other mental or physical issues?
Any accident or birth issue?
He feels but no control on urine and stool or he is not aware of it?
Any weakness of limbs?
Any other complaints?
Taking any treatment?
Any other chronic illness?
Hope to hear from you soon.
Good luck.
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Richa Agarwal (59 minutes later)

hello.

he has always been this way. he isn't aware when he needs the loo and doesn't realise when he has done it either
his other milestones have been as expected
we have been told his legs are week
we have been told he has anxiety issues
he was in hospital in November 2014 when he split his head open and knocked himself out. his left eye was drooping and the doctor wondered if he had nerve damage but wasn't sure if that was from birth or the accident. but looking back old photos, his eye has always been like that.
his birth wasn't easy. we felt that the midwives yanked him out by the head. he was getting distressed and swallowed some meconium.

Answered by Dr. Richa Agarwal (14 hours later)

Brief Answer:
You should consult a paediatric neurologist for the same.

Detailed Answer:
Hello,
Sorry for such a long delay in my response.
I have gone through your history and in my opinion it could be due to pshychiatric illness but before we think over it,I would suggest you to consult a neurologist and get her detailed physical examination and investigation done to rule out the neurological causes.
These symptoms could be due to spinal cord problem or it could be due to local pathology but as he is having weakness of limbs,dropping of eye,we should rule out neurological causes.
Hope found useful.
Good luck.
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Richa Agarwal (41 minutes later)

we are having a lot of problems with our doctors who say it is our fault for not trying hard enough to train him. we would struggle to get referred to a neurologist or any one else because as far as they are concerned it is our fault.

Answered by Dr. Richa Agarwal (12 hours later)

Brief Answer:
It is very important to take neurologist opinion once.

Detailed Answer:
Hello dear,
Sorry for such a long delay once again and I feel very sorry about it.
His symptoms could be due to improper potty and urine training but in my opinion before labeling it we should consult a Neurologist for thorough examination and take his opinion about it.
If no neurological disorder find out then we can see other aspects of it.
Sorry but I could not examined him and unable to give you either he is suffering from neurological disorder or not, you have to consult a neurologist for the same ,so kindly get it done before reaching on any conclusion.
Hope found useful.
Good luck.
Regards

Above answer was peer-reviewed by : Dr. Raju A.T