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An Exploratory Electrical Stimulation Protocol in the Management of an Infant With Spina Bifida: A Case Report

Gerti Motavalli1, Jan J McElroy2, Gad Alon3

  • 1Columbia, MO, USA.

Child Neurology Open
|July 2, 2019
PubMed

Insights

Electrical stimulation, including functional electrical stimulation and transcutaneous spinal cord electrical stimulation, showed promise in an infant with myelomeningocele. This innovative treatment led to unexpected improvements in sensation and movement.

Area of Science:

  • Pediatric Neurology
  • Rehabilitation Medicine
  • Biomedical Engineering

Background:

  • Myelomeningocele, a severe birth defect, often results in significant neurological deficits, including sensory loss and motor paralysis below the affected spinal cord level.
  • Current management for myelomeningocele focuses on surgical repair and supportive care, with limited options for functional recovery in cases of severe spinal cord underdevelopment.
  • Early intervention programs are crucial for maximizing developmental potential in infants with congenital conditions.

Observation:

  • This case report details the treatment of an infant diagnosed with myelomeningocele and thoracic spinal cord underdevelopment.
  • The infant presented with complete sensory loss below T8 and motor paralysis below T10 at 6 months of age.
  • Two electrical stimulation protocols—functional electrical stimulation (FES) and transcutaneous spinal cord electrical stimulation (TSCS)—were integrated into the infant's home-based early intervention program.

Findings:

  • Following 12 months of FES and TSCS, the infant unexpectedly exhibited the emergence of somatosensory responses and spontaneous motor activity in the trunk and lower extremities.
  • These findings suggest a potential for neuroplasticity and functional improvement even in cases of severe spinal cord underdevelopment.
  • The application of TSCS for myelomeningocele management is novel, with no prior descriptions in the medical literature.

Implications:

  • This case suggests that FES and TSCS may be safe and effective adjunct therapies for infants with myelomeningocele, potentially improving neurological function.
  • The observed improvements highlight the possibility of neuro-modulation and recovery in pediatric spinal cord conditions.
  • Further research is warranted to explore the long-term efficacy and broader applicability of these electrical stimulation techniques in managing spina bifida.

Keywords:
Meningomyeloceleelectrical stimulationfunctionalspinal cord

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