What is a plausible etiology of seizures in children with spina bifida?

• A. Brain malformation
• B. CSF shunt infection/malfunction
• C. Genetic epilepsy syndrome
• D. Metabolic disorder

Answer: (A)

Seizures in children with spina bifida most plausibly come from brain abnormalities that accompany the spinal defect. Myelomeningocele often coexists with Chiari II malformation and hydrocephalus, as well as cortical malformations. These brain changes disrupt normal electrical activity in the brain, creating a substrate that makes seizures more likely. While a shunt infection or malfunction can trigger seizures, that is a complication rather than the typical underlying cause in this context. Genetic epilepsy syndromes or metabolic disorders are less directly linked to the spinal defect and are not the most likely explanation for seizures seen with spina bifida. So, the presence of brain malformations associated with the condition best explains why seizures occur in these children.