A Case of Painful Legs and Moving ToesSyndrome Responsive to Gabapentin

ABSTRACT

The syndrome of painful legs and moving toes (PLMT) is a rare movement disorder characterized by severe burning pain in legs associated with peculiar involuntary movements of toes and is difficult to treat. A 70-year-old woman presented with severe lancinating pain in the area below both knees and involuntary movements of both toes for 18 months. The pain in her legs was not relieved by motion. The involuntary movements comprised flexion, extension, adduction, and abduction of toes with occasional rotatory movements of both feet continuing while awake. She had a history of laminectomy of the lower lumbar spine about 15 years ago. Electromyography findings were consistent with chronic lumbosacral polyradiculopathy. Benzodiazepines, carbamazepine, baclofen, and anti-depressants were not effective in reducing her symptoms. However, gabapentin relieved the sensory and motor symptoms significantly. This is the first case of PLMT syndrome reported in Korea which showed a dramatic response to gabapentin.