Think about health promotion opportunities in your clinical practice related to neurological problems, with the following information in mind:

Folic acid supplements

One of the most significant stages of neurological development in the embryo occurs at around 28 days when the neural tube is formed.  Primary neurulation is the term used to describe this process and relies on the presence of folate dependant enzymes (Thompson, 2014).  It is thought that neural tube defects (NTD) such myelomeningocele (see spinal abnormalities in Table 20.3) occur because the neural tube fails to adequately form.  It is thought to occur partly due to insufficient amounts of maternal folic acid.  Approximately 75 infants a year are born in the UK with severe disabilities as a result of NTD (Morris et al., 2015).

Watch the process of primary neurulation here:  www.youtube.com/watch?v=Cu4lQYbOzzY

In the UK it is recommended that women take a daily supplement of 400 micrograms of folic acid while they are trying to conceive and should continue during the first 12 weeks of pregnancy to reduce the chances of having a baby with a neural tube defect (NTD).  However, research has shown that just 28% of women take folic acid supplements prior to conception. Folate (the natural form of folic acid) can be found in green, leafy vegetables, brown rice, nuts, granary bread and breakfast cereals fortified with folic acid.  In the USA since 1998 manufacturers have fortified flour with folic acid and this has been associated with a 23% decrease in pregnancies with NTDs.  There are calls for a similar policy to be adopted in the UK (Morris et al., 2015).

Watch this video to find out more about neural tube defects: www.youtube.com/watch?v=dbnvN3RTuzg