Painful limbs/moving extremities

Abstract

Painful limbs/moving extremities (PLME) is a disorder characterized by spontaneous, complex, slow (1-2 Hz) involuntary toe or finger movements. The movements that can be bilateral or unilateral are usually accompanied by pain in the affected limbs. Painless variants are less common. PLME has been associated with peripheral and central nervous system disease although idiopathic cases have been reported. Its etiopathogenesis is unknown and treatment approaches remain largely empirical. Nerve blocks and botulinum toxin type A injections as well as oral medication have had some measure of success. Current theories suggest that central oscillator(s) at the spinal or supraspinal levels may be involved. Future research in PLME should include prospective electrophysiological and functional imaging studies as well as clinical trials with botulinum toxin injections and oral pharmacological agents.

Movement disorders in patients with diabetes mellitus

“…Treatment includes oral medications such as gabapentin, pregabalin, amitriptyline, quetiapine, carbamazepine, baclofen and clonazepam [47,52]. Botulinum toxin injections have been reported to be useful in a few patients [47,52]. Other modalities of treatment include nerve blocks, epidural blocks, neurectomies, transcutaneous electrical nerve stimulation, vibratory and tactile stimulation, spinal cord stimulation, immersion in cold or hot water and local pressure [47,52].…”

“…The pain is usually described as burning, numb, dull, sharp, shooting, crushing, throbbing or aching pain [47,52]. Treatment includes oral medications such as gabapentin, pregabalin, amitriptyline, quetiapine, carbamazepine, baclofen and clonazepam [47,52]. Botulinum toxin injections have been reported to be useful in a few patients [47,52].…”

“…In PLMT, pain is usually the most debilitating symptom and is the reason for medical treatment rather than the movement itself [47]. The pain is usually described as burning, numb, dull, sharp, shooting, crushing, throbbing or aching pain [47,52]. Treatment includes oral medications such as gabapentin, pregabalin, amitriptyline, quetiapine, carbamazepine, baclofen and clonazepam [47,52].…”

“…Pain is usually the first symptom and may precede involuntary movements by days to years though the reverse may occur [52]. In PLMT, pain is usually the most debilitating symptom and is the reason for medical treatment rather than the movement itself [47].…”

Case Reports: Painful Limbs/Moving Extremities

“…A similar and more common syndrome in the lower extremity is called painful legs and moving toes (PLMT), first coined by Spillane et al [32] in 1971. Papapetropoulos and Argyriou [20] described these disorders as painful limbs/moving extremities (PLME). These were divided into several subtypes according to localization of movement and pain and laterality of symptoms.…”