Third-Party Focal Cutaneous Pressure Suppresses Movements in Coexisting Painful Legs and Moving Toes Syndrome and Electrophysiologically Supported Propriospinal Myoclonus: A Quantitative Case Report
Jo Van Vaerenbergh*
SPINDLE, Route du Rawil 27, 1950 Sion, Switzerland.
*Corresponding Author: Jo Van Vaerenbergh, SPINDLE, Route du Rawil 27, 1950 Sion, Switzerland. Email: jo.vanvaerenbergh@spindle.rehab
DOI: https://doi.org/10.58624/SVOANE.2026.07.022
Received: July 21, 2026
Published: August 03, 2026
Citation: Van Vaerenbergh J. Third-Party Focal Cutaneous Pressure Suppresses Movements in Coexisting Painful Legs and Moving Toes Syndrome and Electrophysiologically Supported Propriospinal Myoclonus: A Quantitative Case Report. SVOA Neurology 2026, 7:4, 150-159. doi.org/10.58624/ SVOANE.2026.07.022
Abstract
Background: Painful legs and moving toes syndrome (PLMT) is a rare sensorimotor disorder characterized by lower-limb pain and involuntary toe or foot movements. Propriospinal myoclonus (PSM) is an uncommon axial movement disorder for which clinical characterization should be supported by multichannel electromyography and electroencephalographic back-averaging. Quantified modulation of coexisting PLMT and electrophysiologically supported PSM by focal somatosensory input is scarcely documented.
Case presentation: A 57-year-old man presented with painful continuous movements of the right toes and foot, superimposed jerks involving the lower limb, and a perceived abdominal onset with spread toward the limb. Surface polymyography showed electromyographic bursts longer than 100 ms with synchronous agonist–antagonist co-contraction; jerk-locked EEG back-averaging identified no time-locked cortical correlate, and video-polysomnography characterized sleep-onset-related movements. Brain and spinal magnetic resonance imaging, nerve-conduction studies, routine electromyography, and dopamine-transporter imaging did not identify an explanatory lesion or parkinsonian degeneration. Pramipexole produced no meaningful benefit. Several cutaneous sites were tested, but only direct manual pressure on the skin over the right T7–T8 region, when continuously applied by another person, markedly suppressed the movements. Self-administered pressure and transcutaneous electrical nerve stimulation did not.
Quantitative findings: Two repeated 10-second two-axis accelerometry recordings were analysed in each condition. Without pressure, a shared 5.2–5.5 Hz component was present in both axes. With pressure, vector root-mean-square acceleration decreased by 72.0% and 59.4% across the two trials, while 1–20 Hz acceleration power decreased by 92.2% and 83.5%. Amplitude at the unstimulated dominant frequency decreased by 91.6%–99.2% across axes. Results remained comparable after excluding 0.5 seconds at each recording boundary. Conclusion: Externally applied focal pressure reproducibly disrupted a coherent oscillatory movement pattern in coexisting PLMT and electrophysiologically supported PSM. The site specificity and failure of self-applied pressure suggest an interaction between localized afferent input and internal prediction of self-generated sensory consequences. The intervention response does not by itself establish whether the modulating mechanism is spinal, supraspinal, functional, or mixed.
Keywords: Painful Legs and Moving Toes; Propriospinal Myoclonus; Functional Movement Disorder; Sensory Modulation; Cutaneous Pressure; Accelerometry; Case Report
