Active Ingredients: Gabapentin
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PoLMT has been described in a patient with Wilson disease and was temporary for 3 months and accompanied the extrapyramidal exacerbation of Wilson disease.
PLMT was also described to be temporary with the use of vincristine and metronidazole, symptoms subsided 6 weeks after stopping the treatment.
Other possible associations of PLMT can be hormonal.
Management The disease can be primary or secondary. Cases which are associated with a certain pathology or related to drug intake are usually curable.
Therefore, a thorough medical history and comprehensive clinical examination should be obtained to distinguish primary from secondary cases.
In a case series of 14 patients, the most effective treatment to relieve pain and movement was GABAergics including gabapentin, pregabalin and progabide.
Pain in the legs has been controlled with dual use of transcutaneous electrical nerve stimulation and vibratory stimulation.
A number of management strategies have been suggested including antiepileptics, antidepressants, benzodiazepines, local nerve block, sympathetic block, lumbar epidural block, and botulinum toxin type A injection.
One case of PoLMT has shown complete control of toe movement with a low dose of clonazepam. Different treatment strategies were discussed with the patient in this report including oral medication, nerve block, botulinum toxin, and surgical treatment of the cyst and the disc prolapse.
It was explained that results obtained from these strategies were not guaranteed.
Our patient was only concerned about the cosmetic appearance of her moving toes and thus preferred not to go through any invasive surgeries. An initial dose of gabapentin 100 mg once daily was prescribed.
Our patient described a modest response to treatment. Finally, she preferred not to increase the dose and she voluntarily discontinued the treatment.
The previously reported case was associated with bilateral PLMT.