Based on 20 years of interdisciplinary expertise of management of the spastic foot, guidance was established to clarify a complex problem in order to help clinicians treat spastic equinovarus foot. This work should be the first step in a more global international consensus.

Literature regarding cases of pregnant patients with hereditary spastic paraparesis (Strumpell-Lorrain disease) and those treated by intrathecal baclofen therapy is sparse. There are currently no specific guidelines to manage pregnancy and delivery in these patients. A 42-year-old woman presented to our clinic with hereditary spastic paraparesis and was treated with intrathecal baclofen for spasticity. She conceived twice and delivered successfully by caesarean section under subarachnoid anaesthesia. The two pregnancies had favourable outcomes with no increase in spasticity and no problems encountered with the intrathecal device. In this report, we discuss the evolution of both pregnancies and the anaesthetic management for deliveries in the presence of an intrathecal catheter. Keywords: Caesarean section; case report; hereditary spastic paraparesis; intrathecal baclofen; pregnancy.

Background Cataract surgery is one of the most frequent surgeries in the world. It is a very safe procedure mostly performed under topical anesthesia in outpatients centers. Due to the growing lack of anesthesiologists, cataract surgeries are more frequently performed without an anesthesiologist present in the operating room. Although extremely rare, life-threatening complications may occur. Cases presentation We report two cases of cataract surgery complicated by severe hypotension that required emergency resuscitation in the immediate postoperative period and hospitalization in intensive care unit. Anaphylactic shock was confirmed in the first case and suspected in the second. Conclusions and importance Even though cataract surgery is a very safe procedure, it is essential to ensure the presence of an anesthesiologist to manage potential, though extremely rare, life-threatening complications such as anaphylactic reactions.

We present the case of a posttraumatic C6 AIS A tetraplegic patient with spasticity treated with an intrathecal baclofen pump, who noticed a transient increase in his spasticity each time he used a digital tablet (Ipad) protected by a magnetic shell placed on his abdomen. Telemetry confirmed transient motor shutdown responsible for withdrawal symptoms each time the tablet was used. Symptoms resolved after the removal of the protective shell. Effects of magnetic fields like magnetic resonance imaging are known to stall the pump rotor, which recover at the end of magnetic resonance imaging. Other sources of magnetic fields like laptops or new smartphones with magnet charging technology may also interfere with implanted devices. We therefore recommend patients to avoid close contact of magnetic devices with the intrathecal baclofen pump. More robust studies are warranted to assess the effect of the new magnetic technologies on the function of intrathecal pumps.

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