"Painless legs moving toes" triggered by ischemic stroke

Haloperidol-induced painless legs and moving toe syndrome in a schizophrenia patient: a case report

Painless legs and moving toe syndrome (PoLMT) is a rare syndrome characterized by involuntary movements of the toe without pain. The exact etiology of the patient's PoLMT is unknown. We present a case of PoLMT in 45-year-old woman with a history of haloperidol intake for 10 months. Haloperidol was discontinued, and aripiprazole (15 mg) was initiated. After this switch, a reduction in movement was observed in the third and fourth toes; however, the second toe showed no discernible change.

Low dose of clonazepam is effective in the treatment of painless legs and moving toes syndrome: a case report

Introduction

Painless legs and moving toes syndrome (PoLMT) is a rare movement disorder characterized by flexion, extension, abduction, adduction, and torsion of toes in the absence of pain. It is considered a variant of painful legs and moving toes syndrome, which is characterized by similar movements but is accompanied by pain. Although neuropathy, spinal cord compression, brain tumor, cerebral infarction, and Wilson's disease have been reported to be associated with PoLMT, the actual cause, trigger, and mechanism remain unclear. Therefore, a standardized treatment for PoLMT is not established yet.

Case Presentation

We describe a 64-year-old Japanese woman with no past medical history who presented with nonrhythmic repetitive involuntary toe movement of the left foot in the absence of pain. She was diagnosed with idiopathic PoLMT and treated with a low dose of clonazepam (0.5 mg/day). The involuntary movement disappeared completely several days after treatment.

Conclusion

A low dose of clonazepam is effective in the treatment of PoLMT.