Painful Legs and Moving Toes Syndrome: Case Report and Review

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 pati...

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Main Authors: Mihael Tsalta-Mladenov, Vladina Dimitrova, Silva Andonova
Format: Article
Language:English
Published: MDPI AG 2024-11-01
Series:Neurology International
Subjects:
Online Access:https://www.mdpi.com/2035-8377/16/6/102
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author Mihael Tsalta-Mladenov
Vladina Dimitrova
Silva Andonova
author_facet Mihael Tsalta-Mladenov
Vladina Dimitrova
Silva Andonova
author_sort Mihael Tsalta-Mladenov
collection DOAJ
description 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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spelling doaj-art-74f4d28974ea47b2ab2d743c64bd9e8a2025-08-20T02:01:08ZengMDPI AGNeurology International2035-83772024-11-011661343135410.3390/neurolint16060102Painful Legs and Moving Toes Syndrome: Case Report and ReviewMihael Tsalta-Mladenov0Vladina Dimitrova1Silva Andonova2Second Clinic of Neurology with ICU and Stroke Unit, University Hospital “St. Marina”, 9000 Varna, BulgariaSecond Clinic of Neurology with ICU and Stroke Unit, University Hospital “St. Marina”, 9000 Varna, BulgariaSecond Clinic of Neurology with ICU and Stroke Unit, University Hospital “St. Marina”, 9000 Varna, BulgariaIntroduction: 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.https://www.mdpi.com/2035-8377/16/6/102painful legs and moving toes syndromePLMTMovement Disorderrestless legs syndromepainpainful legs
spellingShingle Mihael Tsalta-Mladenov
Vladina Dimitrova
Silva Andonova
Painful Legs and Moving Toes Syndrome: Case Report and Review
Neurology International
painful legs and moving toes syndrome
PLMT
Movement Disorder
restless legs syndrome
pain
painful legs
title Painful Legs and Moving Toes Syndrome: Case Report and Review
title_full Painful Legs and Moving Toes Syndrome: Case Report and Review
title_fullStr Painful Legs and Moving Toes Syndrome: Case Report and Review
title_full_unstemmed Painful Legs and Moving Toes Syndrome: Case Report and Review
title_short Painful Legs and Moving Toes Syndrome: Case Report and Review
title_sort painful legs and moving toes syndrome case report and review
topic painful legs and moving toes syndrome
PLMT
Movement Disorder
restless legs syndrome
pain
painful legs
url https://www.mdpi.com/2035-8377/16/6/102
work_keys_str_mv AT mihaeltsaltamladenov painfullegsandmovingtoessyndromecasereportandreview
AT vladinadimitrova painfullegsandmovingtoessyndromecasereportandreview
AT silvaandonova painfullegsandmovingtoessyndromecasereportandreview