The pain had been such that she have been opiate dependent for many months, had been unable to keep functioning and had ultimately been treated with disc decompression that had just marginally helped her discomfort. By the time of the consultation, however, she was managing better but the significant problem was with persisting weakness and paraesthesia.Her only current regular medicine was gabapentin. What has happened to Wilma and how should she be managed?. A cause of cauda equina syndrome How would you manage this female who has persisting weakness and paraesthesia after being treated surgically for acute compressive cauda equina syndrome? Case scenario Wilma, aged 51 years, presented for help for her depression.Bomback. ‘These early data suggest that Acthar could be a practical treatment choice for resistant nephrotic syndrome due to idiopathic membranous nephropathy.’ Acthar is indicated to induce a diuresis or a remission of proteinuria in the nephrotic syndrome without uremia of the idiopathic type or that due to lupus erythematosus. Related StoriesResearchers successfully repair nerve cell harm in Alzheimer's dementiaStudy shows promise for developing targeted treatments for multiple sclerosisStudy reveals mechanism behind protein-related diseases’This new data is encouraging, and demonstrates that Acthar is a potentially important treatment choice for sufferers with nephrotic syndrome due to idiopathic membranous nephropathy.