In a 60-year-old woman diagnosed with painless legs and moving toes associated with multiple system atrophy of cerebellar type, treatment with levodopa was associated with a complete resolution of the involuntary movement, according to a clinical case published in Neurology.

The patient presented with signs and symptoms compatible with multiple system atrophy and a 4-year history of involuntary movement, consisting of painless semirhythmic, semicontinuous flexion-and-extension of the toes.

A comprehensive investigation, including nerve conduction studies and magnetic resonance imaging scans of her lumbosacral spine, was unremarkable. Dopamine transporter imaging was completed due to slight rigidity in her right arm. Findings indicated reduced uptake bilaterally that was more prominent on the left side.


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The patient was diagnosed with painless legs and moving toes associated with multisystem atrophy and, following levodopa treatment, the involuntary movements completely resolved.

Reference

Araki T, Mukai T, Araki T. Treatment of painless legs and moving toes syndrome associated with multiple system atrophy with levodopa. Neurology. Published online May 27, 2021. doi:10.1212/WNL.0000000000012303