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Painful legs and moving toes
Igor de Assis Franco1, Thiago Cardoso Vale2, Vitor Henrique Schulze3
1Department of Neurology, Hospital e Maternidade São José, Conselheiro Lafaiete, Brazil igorafranco1@gmail.com.
Practical Neurology
|April 20, 2021
Summary
A patient developed painful legs and moving toes syndrome after ankle surgery due to deep peroneal nerve injury. Standard medications were ineffective for this rare condition.
Area of Science:
- Neurology
- Orthopedic Surgery
Background:
- Peripheral nerve injuries can lead to complex and persistent neurological symptoms.
- The syndrome of painful legs and moving toes (PLMT) is a rare condition often associated with nerve damage.
Purpose of the Study:
- To report a case of painful legs and moving toes syndrome triggered by a deep peroneal nerve injury post-arthroscopy.
- To highlight the diagnostic challenges and treatment resistance in this specific peripheral nerve injury presentation.
Main Methods:
- Clinical case presentation of a 40-year-old woman with post-arthroscopy ankle pain and involuntary toe movements.
- Diagnostic workup included neurological examination and nerve conduction studies to identify deep peroneal nerve axonal injury.
Main Results:
- The patient exhibited involuntary toe movements (hallux and other toes) and reduced sensation in the toe web space.
- Nerve conduction studies confirmed axonal injury of the deep peroneal nerve.
- Symptoms persisted despite trials of pregabalin, gabapentin, and amitriptyline.
Conclusions:
- Deep peroneal nerve injury can precipitate the syndrome of painful legs and moving toes.
- This case underscores the potential for persistent symptoms and limited response to pharmacotherapy in provoked PLMT syndrome.
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