Unilateral painful legs and moving toes syndrome with moving fingers—evidence for distinct oscillators

Ebersbach, Georg; Schelosky, Ludwig; Schenkel, Andreas; Scholz, Udo; Poewe, Werner

doi:10.1002/mds.870130617

Cited by 24 publications

(18 citation statements)

References 9 publications

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“…1 Since then, few cases have been reported, generally in patients with peripheral nerve, plexus, or root disease. [2][3][4] Deep aching or pulling pain often precedes movements by several months. Involuntary movements are composed of complex sequences of flexion/extension and abduction/adduction, which cannot be imitated.…”

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confidence: 99%

Transcranial cerebral herniation after chronic subdural hematoma treatment with no dura closure

Doglietto¹,

Sabatino²,

Policicchio³

et al. 2006

Neurology

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Abstract-The authors report a patient with unilateral painful hand and moving finger in whom tactile stimulation interrupted both the movement and the pain. This effect suggests a gating mechanism at a segmental level. The difference between afferent and efferent pathway levels and the delay of several months between trauma and occurrence of symptoms support a central mechanism, most probably involving sensorimotor reorganization at a segmental level. NEUROLOGY 2006;67:491-493 C. Wider, MD; T. Kuntzer, MD; P. Olivier, MD; D. Debatisse, MSc; R. Nançoz, MD; P. Maeder, MD; J. Bogousslavsky, MD; and F. Vingerhoets, MD Painful hand and moving fingers (PHMF) was first described in 1985 in a patient suffering from radiation-induced brachial plexopathy, with pain and movements of all fingers. 1 Since then, few cases have been reported, generally in patients with peripheral nerve, plexus, or root disease.2-4 Deep aching or pulling pain often precedes movements by several months. Involuntary movements are composed of complex sequences of flexion/extension and abduction/adduction, which cannot be imitated. Treatment is unsatisfactory. Similar symptoms occur in the inferior limb in the much more common syndrome of painful legs and moving toes (PLMT). 5,6 We report a patient with unilateral PHMF after median nerve lesion in whom tactile stimulation in the same territory simultaneously interrupted both the movement and the pain.Case report. A 55-year-old woman was referred to our center for pain and movement in the left hand. Two years before, she had suffered traumatic fracture of the left distal part of the radius bone. After conservative treatment, she developed continuous pain, hyperalgesia, and sudomotor changes and was diagnosed with complex regional pain syndrome (CRPS), treated by pamidronate and calcitonin for 2 years. She reported no abnormal movement. Nine months before our evaluation, she had median nerve surgical decompression of the carpal tunnel. Two months later, she developed involuntary movement of the third left finger, followed after another 2 months by sharp pain in the hand with third finger predominance. Upon notice that it would help both the pain and the movement, she started wearing a glove.Physical examination showed continuous involuntary pseudorhythmic and rapid movements of the third left finger, at a frequency of 3 to 5 Hz, with predominance of flexion/extension but with some abduction/adduction component that sometimes gave it a rotating aspect (see video, segment 1 on the Neurology Web site at www.neurology.org). The patient could not willingly stop the movement, nor would contralateral action either reduce or increase it. Tactile stimulation of the palmar aspect of the first to third fingers immediately, simultaneously, and completely stopped both the movement and the pain (video, segment 2), as would pinprick and fork application. In contrast, stimulation outside the median territory on the internal aspect of the hand or on the dorsal aspect of the fingers did not affect either the moveme...

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confidence: 99%

Transcranial cerebral herniation after chronic subdural hematoma treatment with no dura closure

Doglietto¹,

Sabatino²,

Policicchio³

et al. 2006

Neurology

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“…Since then painful limbs/moving extremities has been identified as a syndrome with many variants (painless [7] , unilateral [8] , involving only arms [4] , only legs [1] or both [8] ).…”

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confidence: 99%

Moving Fingers Associated with Dupuytren’s Disease: A Case Report

et al. 2007

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“…Ebersbach et al 15 reported a patient with unilateral PLMT who 2 months later developed involuntary finger movements in the ipsilateral hand. The authors suspected separate central oscillators for toe and finger movements based on hand and foot EMG asynchrony.…”

Section: And Thementioning

confidence: 99%

Bilateral painful hand-moving fingers: Electrophysiological assessment of the central nervous system oscillator

et al. 2000

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Unilateral painful legs and moving toes syndrome with moving fingers—evidence for distinct oscillators

Cited by 24 publications

References 9 publications

Transcranial cerebral herniation after chronic subdural hematoma treatment with no dura closure

Transcranial cerebral herniation after chronic subdural hematoma treatment with no dura closure

Moving Fingers Associated with Dupuytren’s Disease: A Case Report

Bilateral painful hand-moving fingers: Electrophysiological assessment of the central nervous system oscillator

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