Reich Stephen G
Department of Neurology, Maryland Parkinson's Disease and Movement Disorders Center, University of Maryland School of Medicine, Baltimore 21201, USA.
Handb Clin Neurol. 2011;100:375-83. doi: 10.1016/B978-0-444-52014-2.00029-X.
The syndrome of painful legs-moving toes (PLMT) is an adult-onset, rare disorder characterized by pain, typically of a neuropathic quality, in the feet or legs, associated with writhing movements of one or more toes. It is the pain which usually brings the patient to medical attention. The syndrome may be unilateral or bilateral. Identical toe movements may occur without pain, referred to as: "painless legs-moving toes," and a similar condition affects the upper limbs: "painful arms-moving fingers." The pathophysiology of PLMT and its variants is not known but most reports suggest an association with a peripheral lesion, usually at the level of the root or nerve, though in many cases no cause is found. It has been suggested that a peripheral lesion causes aberrant input leading to "central reorganization," probably at the level of the spinal cord, and that the latter is responsible for the pain and movement. Treatment is often unsatisfactory and many drugs commonly used for neuropathic pain have been reported anecdotally to help (e.g., gabapentin). Other anecdotal therapies include spinal blocks, spinal cord stimulation, and local injection of botulinum toxin.
痛性腿部 - 舞动脚趾综合征（PLMT）是一种成人起病的罕见疾病，其特征为足部或腿部疼痛，通常具有神经性疼痛的性质，并伴有一个或多个脚趾的扭动动作。通常是疼痛促使患者就医。该综合征可为单侧或双侧。相同的脚趾动作也可能在无疼痛的情况下发生，称为“无痛性腿部 - 舞动脚趾”，类似情况也会影响上肢，称为“痛性臂部 - 舞动手指”。PLMT及其变体的病理生理学尚不清楚，但大多数报告表明与周围病变有关，通常发生在神经根或神经水平，不过在许多情况下未发现病因。有人认为周围病变会导致异常输入，可能在脊髓水平引发“中枢重组”，而后者是疼痛和运动的原因。治疗往往不尽人意，据传闻，许多常用于神经性疼痛的药物有帮助作用（如加巴喷丁）。其他传闻的治疗方法包括脊髓阻滞、脊髓刺激和局部注射肉毒杆菌毒素。
