Spina bifida is a serious birth defect that occurs when the tissue surrounding the developing spinal cord of a fetus doesn't close properly. Spina bifida, which literally means "cleft spine," is characterized by the incomplete development of the brain, spinal cord, and/or meninges (the protective covering around the brain and spinal cord).   It is the most common neural tube defect in the United States?affecting 1,500 to 2,000 of the more than 4 million babies born in the country each year. Doctors aren't certain why neural tubes don't develop or close properly in some babies. As with many other problems, it appears to result from a combination of genetic and environmental risk factors, such as a family history of neural tube defects, folic acid deficiency, and medical conditions such as diabetes and obesity.

The human nervous system develops from a small, specialized plate of cells along the back of an embryo.  Early in development, the edges of this plate begin to curl up toward each other, creating the neural tube?a narrow sheath that closes to form the brain and spinal cord of the embryo.  As development progresses, the top of the tube becomes the brain and the remainder becomes the spinal cord.  This process is usually complete by the 28th day of pregnancy.  But if problems occur during this process, the result can be brain disorders called neural tube defects, including spina bifida. There are four types of spina bifida:   occulta, closed neural tube defects, meningocele, and myelomeningocele. Occulta is the mildest and most common form in which one or more vertebrae are malformed. 

The name "occulta," which means "hidden," indicates that the malformation, or opening in the spine, is covered by a layer of skin.  This form of spina bifida rarely causes disability or symptoms.  Closed neural tube defects make up the second type of spina bifida.  This form consists of a diverse group of spinal defects in which the spinal cord is marked by a malformation of fat, bone, or membranes.  In some patients there are few or no symptoms; in others the malformation causes incomplete paralysis with urinary and bowel dysfunction. In the third type, meningocele, the meninges protrude from the spinal opening, and the malformation may or may not be covered by a layer of skin.  

Some patients with meningocele may have few or no symptoms while others may experience symptoms similar to closed neural tube defects. Myelomeningocele, the fourth form, is the most severe and occurs when the spinal cord is exposed through the opening in the spine, resulting in partial or complete paralysis of the parts of the body below the spinal opening.   

The paralysis may be so severe that the affected individual is unable to walk and may have urinary and bowel dysfunction. The exact cause of spina bifida remains a mystery. No one knows what disrupts complete closure of the neural tube, causing a malformation to develop. Scientists suspect genetic, nutritional, and environmental factors play a role.  Research studies indicate that insufficient intake of folic acid (a common B vitamin) in the mother's diet is a key factor in causing spina bifida and other neural tube defects.

New research also indicates that the bi-polar medication Depakote may cause spina bifida. Depakote is a widely used drug marketed by Abbott Laboratories to treat long-term manic and depressive parts of rapidly-cycling bipolar disorder. Other uses of Depakote include treating patients for migraines, epilepsy and chronic pain associated with nervous system diseases (neuropathy).  See: Facts about Depakote - Birth Defects & Spina Bifida