Painless Legs Research Articles

Painless Legs and Moving Toes Syndrome: A Rare Case Presentation.

Painless Legs and Moving Toes Syndrome: A Rare Case Presentation.

Painless Legs and Moving Toes Syndrome (PLMT): A Rare Case Presentation

Painless Legs and Moving Toes Syndrome (PLMT): A Rare Case Presentation

Painless Legs and Moving Toes in Chronic Inflammatory Demyelinating Polyradiculoneuropathy.

Painless Legs and Moving Toes in Chronic Inflammatory Demyelinating Polyradiculoneuropathy.

An Idiopathic Case of Painless Legs and Moving Toes

Painful legs and moving toes is an uncommon movement disorder. A painless variant has been reported in few case reports. Painless legs and moving toes is mainly related to the spinal cord pathologies, or reported as secondary to the neurodegenerative diseases or as a tardive phenomenon. Here we report a 27-year-old female patient complaining of involuntary semi-continuous writhing movements in her toes for 9 years. She had no family history for any movement disorder. As a result of detailed clinical and laboratory investigations including cranial and spinal neuroimaging, biochemical tests, viral serology, autoimmune and paraneoplastic biomarkers, she was diagnosed as having idiopathic painless legs and moving toes.

A Case of Painless Legs and Moving Toes Syndrome in Parkinson's Disease Responsive to Dopaminergic Therapy.

Painless Legs and Moving Toes Syndrome (PoLMT) is a rare movement disorder characterized by flexion, extension, abduction, adduction, and torsion of toes without pain. It is considered a variant of Painful Legs and Moving Toes Syndrome (PLMT), which is characterized by similar movements but with pain. Although neuropathy and several central nervous system (CNS) involvements have been reported to be associated with PoLMT, the actual cause and mechanism remain unclear. Here we describe the first case of PoLMT in Parkinson's Disease (PD), parallel to parkinsonism in severity, who demonstrated a good response to dopaminergic therapy.

Painful and Painless Legs Moving Toes Syndrome: A Polysomnographic and Polymyographic Study (P04.036)

Objective: To characterize the polysomnographic (PSG) and polymyographic (PMG) features of Painful and Painless Legs Moving Toes Syndrome (PPLMTS). Background PPLMTS has been described in isolated case reports in the literature and is clinically manifested as continous or semicontinous involuntary movements of the intrinsic foot muscles, with or without pain. The etiology remains unclear, but predisposing factors are usually peripheral neuropathies and radiculopathies, although central causes have been postulated in cases with antagonistic rather than co-contraction. There have not been any systematic studies elucidating the PSG/PMG findings in patients with this disorder. Design/Methods: Case series. Results: Seven patients (five women, two men) presented to our institution with PPMTS; two had pain with their symptoms and four did not. Two patients had Parkinson9s disease. All patients underwent overnight polysomnography (PSG) with specialized foot montage (extra muscle channels involving bilateral abductor digiti minimi, flexor hallucis brevis and extensor digitorum brevis. In five patients, toe movements were predominantly bilateral and noted to be most frequent in wakefulness and stage N1 as well as sleep-wake transitions. They rarely persisted into REM sleep in three of these patients and were noted to be very frequent in REM sleep in another. They were associated with cortical arousals in both REM and NREM sleep in one patient. The movements were a combination of myoclonic (less than 200 msecs) and dystonic (greater than 200 msecs) bursts, although in two patients the bursts were purely dystonic. Various combinations of synchronous and asynchronous bursts were seen. In two patients, one with Parkinson9s disease, the movements did not persist in sleep. Conclusions: PPLMTS is a clinically and neurophysiologically heterogenous syndrome, with the mixture of myoclonic, dystonic, synchronous and asynchronous patterns suggesting a complex pathophysiology determined by both peripheral afferent and efferent and supraspinal efferent control. Disclosure: Dr. Lysenko has nothing to disclose. Dr. Bhat has nothing to disclose. Dr. Hanna has nothing to disclose. Dr. Siddiqui has nothing to disclose. Dr. Chokroverty has received personal compensation for activities with Elsevier and Cephalon. Dr. Chokroverty has received personal compensation in an editorial capacity for Sleep Medicine Journal.

Gluteal Myokymia, a Proximal Counterpart of Painless Legs, Moving Toes (P04.039)

Objective: The objective of this abstract is to present a unique patient with involuntary movements of gluteus maximus muscles in whom onset, evolution of symproms and electromyographic pattern resembled that of painful legs, moveing toes except it involved the proximal muscles. Background Involuntary ,myokymic movememnts has been described in foot and hand muscles as painful (or painless ) legs moving toes (PLMT) and painful(or painless) moving hands. These myokymic movemnts often arise from injury to peripheral nerves or nerve roots. To our knowledge a myokymic movement with unilatral onset evolving into bilateral movements has not be described before in the gutei muscles. Design/Methods: A 52 year-old female was evaluated for poor balance associated with movements of buttocks for the past 10 years. The movements started in the left side and then became bilateral. She had a history of extensive pelvic endometriosis which required surgical intervention. On examination, involuntary movements were noted in both buttocks involving the gluteus maximus muscles. Results: Electromyography demonstrated ongoing myokymic movements with characteristic periodic pattern . ry sounds. The discharges occured synchronously in both glutei. Magnetic resonance imaging (MRI) of lumbosacral area demonstrated narrowing of L5-S1 foramen with commpression of corresponding nerve root. Cervical and thoracic MRI disclosed no spinal cord pathology. Treatment with onabotulinum toxin -A reduced the movemnts significantly. Conclusions: A syndrome similar to painful legs, moving toes exists in proximal leg muscles. In the case of our patient ,the movements started in one gluteus maximus and then spread to the other side(videotape) suggesting developemt of a spinal loop (as PLMT). Like PLMT, EMG of glutei muscles showed myokymia (videotape). We suggest that root compression on the side of firsr affected gluteus muscle caused the myokymic movements of that muscle. Disclosure: Dr. Sorokin has nothing to disclose. Dr. DiCapua has nothing to disclose. Dr. Mittal has nothing to disclose. Dr. Jabbari has nothing to disclose.

Painless legs and moving toes from parasagittal meningioma

Painless legs and moving toes from parasagittal meningioma

Painless legs and moving toes: Symptom reduction during pregnancy

Painless legs and moving toes: Symptom reduction during pregnancy

Painless legs and moving toes as an initial presentation of ischemic stroke.

Painless legs and moving toes is an unusual syndrome, which has not previously been reported as an initial presentation of ischemic stroke. We encountered a 78-year-old woman who developed dysarthria and involuntary movement of her left toes that was clinically regarded as painless legs and moving toes. These symptoms appeared abruptly and simultaneously as the initial symptoms of stroke, and improved gradually with conservative management by intravenous hydration for a month. We suggest that, in our case, a cortical brain lesion caused by ischemic stroke might be associated with the development of painless legs and moving toes.

Juvenile onset painless legs and moving toes syndrome – report on two families

Juvenile onset painless legs and moving toes syndrome – report on two families

Quetiapine: An alternative treatment in painless legs and moving toes

Quetiapine: An alternative treatment in painless legs and moving toes

“Painless legs and moving toes” syndrome due to spinal cord compression

Painful legs and moving toes is a rare syndrome characterized by spontaneous neuropathic pain in the lower limbs associated with peculiar involuntary movements of the lower extremities, especially the toes and feet. Although its origin is unknown, it is associated to some pathologies. With regard to the painless variant, very few patients have been reported and most of them are idiopathic. We report a patient with involuntary movements of the toes similar to those seen in painful legs and moving toes syndrome, but without any associated pain and due to a spinal compression. We conclude that spinal lesions may produce the painless variant as it has been reported with the painful form.

Painless legs moving toes in a patient with Wilson's disease

We describe and present a video of a 20-year-old woman with Wilson's disease (WD) who developed the painless variant of painful legs and moving toes (PLMT) syndrome. The symptoms appeared during a subsequent minor exacerbation of her extrapyramidal symptomatology, only to gradually disappear 3 to 4 months later. We suggest that, in our case, a structural central nervous system lesion caused by WD may have been associated with the development of PLMT.

Painless legs and moving toes in a mother and her daughter.

Painful legs and moving toes (PLMT) is a rare syndrome which is characterised by involuntary movements of the toes and pain in the legs. We report on a mother and her daughter who both presented with involuntary movements of the toes similar to those seen in PLMT but without any associated pain. Neurological examination revealed intermittent 0.3 to 0.5-Hz flexion and extension of the toes and ankles of the right foot in the mother, and of both feet in the daughter. In both patients, the movements appeared during periods of rest that were uncorrelated with the time of day. Diagnostic work-up gave no evidence of radiculopathy or of focal neuropathy. Overnight polysomnography documented that movements of the toes and feet occurred only before sleep onset and during periods of nocturnal awakening or arousals. Because the movements observed in our patients were similar to those seen in patients with PLMT, we diagnosed an abortive form of this syndrome, which already has got the naming "painless legs and moving toes." The occurrence in a mother and her daughter may point to a hereditary component of this disorder.