Abstract

Moving toes syndrome is characterized by involuntary movements of the toes. Since it is usually accompanied by pain, it is called painful legs-moving toes syndrome. In this article, four patients with painful legs-moving toes syndrome are presented. The first patient was a 20-year-old male who presented with complaints of pain and involuntary movements in the toes bilaterally. The second patient was a 38-year-old female, and although she complained about involuntary movements of the toes bilaterally, she did not describe pain. She also had a history of receiving botulinum toxin injections due to cervical dystonia. The third patient was a 38-year-old female who also presented with painless involuntary movements in the toes. She was also diagnosed with diabetic polyneuropathy during the examinations. The fourth patient was a 42-year-old male who presented with left-prominent involuntary movements in bilateral toes, which were not accompanied by pain. Except for the first patient, 3-5 Hz rhythmic discharges were recorded during polymyography of the patients. Irregular discharges were detected in the first patient. Patients did not have any improvement with the treatment of clonazepam, gabapentin, or pramipexole. The mentioned involuntary movements only affected the lower extremities in the reported patients. The etiology varied. The common feature of these patients was the involuntary writhing movements of toes, which could be painful or painless. These movements are often difficult to treat.