Medications are modestly effective at decreasing the number of attacks in RRMS and in reducing the accumulation of brain lesions, which is measured using gadolinium - enhanced magnetic resonance imaging (MRI).  Interferons and glatiramer acetate are roughly equivalent, reducing relapses by approximately 30% and their safe profile make them the first-line treatments.  Nevertheless, not all the patients are responsive to these therapies. It is known that 30% of MS patients are non-responsive to Beta interferon.  One of the factors related to non-respondance is the presence of high levels of interferon beta neutralizing antibodies . Interferon therapy, and specially interferon beta-1b, induces the production of neutralizing antibodies, usually in the second 6 months of treatment, in 5 to 30% of treated patients.   Moreover, a subset of RRMS patients with specially active MS, sometimes called "rapidly worsening MS" are normally non-responders to immunomodulators and are treated with either mitoxantrone or natalizumab. 
Cauda equina is formed by nerve roots caudal to the level of spinal cord termination. Cauda equina syndrome has been defined as low back pain, unilateral or usually bilateral symptoms in the distribution of sciatic nerve, saddle sensory disturbances, bladder and bowel dysfunction, and variable lower extremity motor and sensory loss. This may occur with neurotoxicity from local anesthesia. In the past, continuous spinal catheters with local anesthetics were associated with this syndrome. Those types of catheters and infusions are no longer in use.
Treatment: If a pancreatic or liver tumor is identified and able to be surgically excised, the skin lesions may normalize for an extended period of time, but because these tumors metastasize (spread to other areas of the body) quickly, surgery is not curative. In cases of end stage liver disease, surgery is not possible, and the goal of therapy is to increase quality of life and decrease uncomfortable skin lesions with supportive care and addressing the nutritional abnormalities. Supportive care includes supplementing protein and necessary minerals and enzymes through the diet and oral supplements or by weekly intravenous amino acid infusions that are performed in the hospital on an outpatient basis until improvement in the skin is noted. Unfortunately, despite the supportive care, the disease will progress.