The mystery of moving toes without or with pain

This rare syndrome is still a mystery. Suddenly, the toes of one or both feet begin to move continuously. Different types of movements are described.
The movements are often irregular and consist of flexion / extension, adduction / abduction, spacing or circular toe movements with sustained contraction from time to time . The patient can interrupt only for a short period of time these movements with a voluntary movement of the foot and toes. The toes do not move during the sleep.
The moving toes are often preceded or accompanied by disabling pain (legs and feet). Hence, the name of the syndrome ” painful legs and moving toes ». This syndrome was first described in the 70’s’. In some cases the syndrome is related to pathologies of the peripheral nerves (polyneuropathy, herniated disc) or spine disease (attached spinal cord syndrome, myelitis). A few cases have been associated with Parkinson’s disease or neuroleptic treatment, chemotherapy, brain tumors, stroke, Wilson’s disease, trauma and thyroid disease.
Most of the time, any cause is detected. The idiopathic form (without apparent causes) affects usually women around the age of 50.
The origin of this syndrome is among the many mysteries of neurology. Is this the resurgence of ancient movements in phylogenesis (type fishes’ fins and gills)?
The evolution can be in the sense of spontaneous remission, stability or progression. Pharmacological treatments (antiepileptics) are partially effective. Treatment with Botox infiltrations can be considered.

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