Painful Legs and Moving Toes Syndrome: Case Report and Review.

Neurol Int

Second Clinic of Neurology with ICU and Stroke Unit, University Hospital "St. Marina", 9000 Varna, Bulgaria.

Published: November 2024

AI Article Synopsis

  • Painful legs and moving toes (PLMT) syndrome is a rare movement disorder involving severe leg pain and involuntary toe movements caused by nerve issues in the lower limbs.
  • This case study presents a 59-year-old man with PLMT due to multiple disc problems in his spine, highlighting how pregabalin, a medication, significantly improved his symptoms during a 90-day follow-up.
  • The conclusion emphasizes that while PLMT is often overlooked by healthcare providers, early treatment with medications like pregabalin is crucial, with additional options available if conservative treatments fail.

Article Abstract

Introduction: Painful legs and moving toes (PLMT) syndrome is a rare movement disorder characterized by defuse lower limb neuropathic pain and spontaneous abnormal, involuntary toe movements.

Objective: The objective was to present a rare case of PLMT syndrome with a triggering area in an adult patient due to multilevel discogenic pathology, to make a thorough review of this disorder and to provide a practical approach to its management.

Case Presentation: A 59-years-old male was admitted to the neurology ward with symptoms of defuse pain in the lower-back and the right leg accompanied by involuntary movements for the right toes intensified by tactile stimulation in the right upper thigh. Magnetic resonance imaging (MRI) revealed a multilevel discogenic pathology of the lumbar and cervical spine, with myelopathy at C5-C7 level. A medication with Pregabalin 300 mg/daily significantly improved both the abnormal toe movements and the leg pain. The clinical effect was constant during the 90-day follow-up without any adverse effects.

Conclusion: Painful legs and moving toes (PLMT) is a condition that greatly affects the quality of life of patients, but which still remains less known by clinicians. Spontaneous resolution is rare, and oral medications are the first-line treatment. Pregabalin is a safe and effective treatment option for PLMT that should be considered early for the management of this condition. Other medication interventions, such as botulinum toxin injections, spinal blockade, or non-pharmacological treatment options like spinal cord stimulation, and surgical decompressions, are also recommended when the conservative treatment is ineffective in well-selected patients.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587123PMC
http://dx.doi.org/10.3390/neurolint16060102DOI Listing

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