Abnormalities of the Body
Thus, spina bifida occulta can be more significant clinically. Symptoms of the abnormality may present at any time from birth to adulthood (16:791792). Furthermore, while no particular ethnic group seems more predisposed to the condition, spina bifida occulta does occur more frequently in females than males: The sex ratio is slightly more than 21, female to male (18:350).

The assorted symptoms of spina bifida occulta may be cutaneous, neurological or orthopedic in nature. Cutaneous signs may include a very hairy patch (hypertrichosis) resembling a horse's tail situated at about midline. In addition, midline lumbosacral portwine angiomas are also frequently associated with the disorder. Other possible signs include pigmented nevi (red to brownish mottled patches) and atretic meningoceles (skin abnormalities consisting of a central thin white area surrounded by a periphery of red, pink or brown), as well as subcutaneous lipomas and dimplelike depressions (18:352353).

Neurological manifestations of spina bifida occulta include muscle weakness and gait disturbance, often with onset at about two years of age (i.e., when the child begins to walk). There may also be unilateral lower extremity muscle atrophy and, possibly, a short leg. Deep tendon reflexes tend to vary considerably; they can be either normal, increased, hypoactive, or completely abs

 
 
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