Painful legs and moving toes syndrome with stimulus-sensitive startle myoclonus
Key points
PLMT may mimic restless legs syndrome, spinal segmental myoclonus, dystonia, peripheral neuropathy or functional neurological disorder.
Slow irregular toe movements occurring at frequencies around 1–2 Hz are characteristic clinical features of PLMT.
This case demonstrates an unusual association between PLMT and stimulus-sensitive startle myoclonus.
Careful phenomenological assessment and video documentation are important in recognising uncommon movement disorders such as PLMT.
Painful legs and moving toes syndrome is a rare and under-recognised movement disorder characterised by chronic lower limb pain with involuntary movements of the toes.1 2 It may mimic more common neurological conditions, including restless legs syndrome, spinal myoclonus, peripheral neuropathy, dystonia and functional neurological disorder and so often there is diagnostic delay.3 4 Although the syndrome has been associated with peripheral nerve injury, radiculopathy, spinal pathology and trauma, the cause often remains unknown.2 3
Case presentationA 56-year-old...
Source: Practical Neurology - Online First Published 02 Nov 2026 Imported 02 Nov 2026 Relevancy: Not reviewed
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