Журнал клинических случаев

Painful Leg Moving Toes Syndrome: A Report of Two Cases and Update of Clinical Manifestation, Pathophysiology and Management

Abstract

Samih Badarny, Yazid Badarny, Kamal Hassan and Adnan Zaina

Introduction: Painful Leg and Moving Toes (PLMT) is a rare disorder of unknown etiology. It is characterized by pain and abnormal movement of toes. These symptoms are troublesome to patients but not life-threatening. There is no curative treatment; however, supportive therapy and symptomatic therapy somewhat ameliorate the conditions. Thus, also to avoid extensive or invasive examinations, physicians should be aware this condition.

Case presentation: The first patient had sensory symptoms that began in both legs, and gradually involuntary movements appeared in the toes of one leg, which spread to the other leg. The second had no leg pain, but involuntary movement of the toes was the sole clinical presentation. Diagnosing these conditions as PLMT, we prescribed pregabalin, clonazepam, baclofen, local corticosteroid injections, epidural blocks and warmwater soaks, which led to partial improvement of these symptoms.

Conclusion: PLMT presents in different forms, symptoms usually do not worsen over time and not life-threatening, and thus, in this sense, benign condition. We, presenting these two cases, wish to update the clinical presentation, electrophysiological findings, pathophysiology, associated diseases, treatment and management of PLMT