I am a Psychologist working in a mental health institution in Portugal. We have recently received a patient with severe behavior modification and impaired cognitive functioning. He is 16 years old and until now he has been considered a "normal adolescent". Some testing is being done and the doctor discovered that he suffers from Spina Bifida, something that until now nobody had known. Could this disease be related to the cognitive and behaviour modification I´ve told you about?

Because this young man has been diagnosed with Spina Bifida at the age of 16, I would guess that he has Spina bifida Occulta. This means that there are no external protrusions of spinal cord tissue above the surface of the skin. This diagnosis means that the vertebrae did not fuse and that there is an opening in the spine. Usually the spinal cord is not affected. Occasionally (and infrequently) there is involvement of the spinal cord, such as a tethered cord or split cord. This can be determined by MRI. However, none of these findings are usually associated with impairments in cognitive function or behavior problems.

If there is hydrocephalus, most often associated with Spina Bifida aperta (open Spina Bifida) and visible spinal cord tissue above the skin layer, then learning and behavior is sometimes affected. Hydrocephalus can be associated with impairments in cognitive function, learning problems, and behavior challenges. Information about Spina Bifida Occulta, as well as the learning challenges and mental health issues that occur in Spina Bifida with hydrocephalus, is available in the Fact Sheets http://www.spinabifidaassociation.org/site/c.liKWL7PLLrF/b.2642343/k.8D2D/Fact_Sheets.htm section.