Pramipexole relieves pain in a patient with painful leg movement disorder

Abstract

We report a patient with a painful leg movement disorder that was relieved with pramipexole. A man in his 60 with pain in the right toes (II-V) and involuntary movement after knee surgery was referred to us. The patient suffered from characteristic symptoms of painful legs and moving toes, such as intractable pain, discomfort, and peculiar involuntary movement of the distal lower legs and toes. The pain was present throughout every day and worsened after walking. The movement was characterized by irregular but persistent tremor of 1-2 Hz with dystonia of the right toes. Repeated caudal blocks and oral pramipexole decreased the pain and involuntary toe movement. This movement and the pain almost disappeared after a weekly increase in the dose of pramipexole with weekly caudal blocks, thus allowing the patient to ambulate. Therefore we conclude that pramipexole may be effective in some patients with painful leg movement disorders.