Botulinum toxin for painful limbs moving extremities: are distal injections critical?

摘要

Since Painful Legs Moving Toes syndrome (PLMT) was first reported in 1971 [1], the syndrome has expanded to include hand movements and painless variants, all of which may be encompassed under the rubric of Painful Limbs Moving Extremities (PLME) [2]. Each is characterized by involuntary movements of toes or fingers, including flexion, extension, abduction, and adduction movements, typically bilateral and asymmetric although occasionally unilateral, and which can be stopped with mental concentration, but reemerge with mental distraction [3] [esupp ref. 1].