Painful legs and moving toes syndrome associated with herpes zoster myelitis

Posterior horn varicella-zoster virus myelitis

“…Our laboratory findings and the good response of our patient to treatment with acyclovir suggest that MRI images may well show direct virus invasion of the spinal cord. The present case along with a few earlier reports [9,10,11], might demonstrate the spread of VZV from the dorsal root ganglia to the posterior horn at several spinal levels, some of which match the dermatome distribution of the vesicular rash. The unexpected central rather than peripheral spread of VZV infection from the dorsal root ganglia into the spinal cord might be facilitated in this patient by an immunodeficiency state resulting from the chemotherapy.…”

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

“…PLMT syndrome has been shown to occur secondary to other neurological disorders (including spinal cord or cauda equina trauma, lumbar radiculopathy, peripheral neuropathy, traumatic lesions of the soft tissue and bone in the foot, during treatment with neuroleptics and herpes zoster infections). However, some cases are idiopathic 8–14. To date, only the latter have been associated with the “painless legs and moving toes” variant,6 which seems to fit our case.…”

Painless Legs and Moving Toes as an Initial Presentation of Ischemic Stroke

“…The mechanism proposed to explain this condition is that of peripheral injury to nerves, plexus or roots, causing an alteration in spinal and/or supraspinal sensory and motor machinery 11–14. Whether the movements in this condition arise in the spinal cord, as suggested by Nathan and Schott,15–17 recent reports suggested that a structural central nervous system lesion might have been associated with the development of PLMT and painless legs and moving toes 8,18…”