Painful leg and moving toes syndrome in secondary tethered cord syndrome.

Context: Painful leg and moving toes (PLMT) syndrome is a rare movement disorder where the patient has pain followed by movement disorder in one or both lower limbs. The exact etiology and pathogenesis is uncertain, however many cases have been related to lesions in peripheral nerve, spinal cord or radicals. Appearance of abnormal movement in PLMT soon after surgery has not, to our knowledge, been described.

Findings: We report a 40-year-old female patient who had secondary tethered cord syndrome. She had pain in left lower limb for 5 months prior to surgery. Immediately after surgery, she noticed abnormal movement in left foot. Surface electromyography suggested single motor unit discharges.

Conclusion/clinical Relevance: In persons with unclear symptoms of painful leg and moving toes, PLMT syndrome should be in the differential diagnosis.