Dramatic Responses to Low-Dose Pramipexole in Painful Legs and Moving Toes Syndrome

Painful legs and moving toes syndrome (PLMTS) is a rare movement disorder characterized by spontaneous abnormal, involuntary toe movements and unilateral or bilateral lower extremity pain that predominantly affects women in middle age or later. The background etiology of PLMTS includes peripheral ne...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2023-02, Vol.15 (2), p.e34763
Main Authors: Umezawa, Gakusuke, Hasegawa, Takafumi, Ikeda, Kensuke, Saito, Genichi, Aoki, Masashi
Format: Article
Language:English
Subjects:
Ankle
Case reports
Dopamine
Etiology
Fingers & toes
Hospitals
Internal Medicine
Medical diagnosis
Nervous system
Neurology
Pain
Pathogenesis
Patients
Peripheral neuropathy
Restless legs syndrome
Spinal cord
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Summary:Painful legs and moving toes syndrome (PLMTS) is a rare movement disorder characterized by spontaneous abnormal, involuntary toe movements and unilateral or bilateral lower extremity pain that predominantly affects women in middle age or later. The background etiology of PLMTS includes peripheral neuropathy, a history of trauma, and nerve root damage, but the cause of the disease is often undetermined. The pain usually occurs first and is often more distressing to the patient than abnormal toe movement. Spontaneous resolution is rare, and symptomatic therapies include the oral administration of anticonvulsants, antidepressants, and various pain relievers, as well as other therapeutic interventions, including botulinum toxin injection and epidural block, but their effectiveness is uncertain. We report a case of PMLTS in which low doses of pramipexole, a non-ergot dopamine agonist, dramatically improved both abnormal toe movement and leg pain, which are documented by videography.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.34763