Cognitive outcome in children with myelomeningocele and perinatal hydrocephalus: A longitudinal perspective

Myelomeningocele, a form of spina bifida where the vertebrae fail to fuse d uring foetal development, is often associated with sensory deficits, reduce d motor function and hydrocephalus. These complications may interfere with the development of the central nervous system affecting myelination of axon s and formation of synaptic connections, and development of cognitive skill s, particularly where complications occur within the first twelve months of life. This paper examines the long-term cognitive outcome in nineteen chil dren with myelomeningocele, who were shunted for hydrocephalus within the f irst year of life. In comparison to a healthy control group matched for age and gender, the clinical sample were found to have globally compromised co gnitive skills, including reduced intellectual and educational skills. Spec ific impairments were noted on measures of speed of processing, immediate r egistration of information, learning and memory, organisation and high leve l language, with greatest deficits on more complex, less structured tasks. Within the clinical group, there was a fall in IQ over time, suggesting a f ailure to acquire cognitive skills in the expected time frame. These result s, reflecting a cumulative pattern of deficits over time, highlight the imp ortance of long-term follow lip in children with myelomeningocele and perin atal hydrocephalus.