Right Arm weakness with mild atrophy in right hand

[[CR...]]

I've been tapering off 2 mg/day Clonazapam for the last 7 months, and now take 0.75 mg/day.

 

Four weeks ago I suddenly developed weakness and clumsiness in my right hand, and noticed mild atrophy in the palm muscle that abducts the pinky. The weakness is mostly limited to functions of the Ulnar nerve, but I've had weird sensations throughout the entire arm the would also include the Median and Radial nerves.  The neurologist and orthopedic hand doctor couldn't find anything wrong with the hand, and my nerve condition and EMG tests were normal.  Even so I'm having a difficult time typing this.

 

Does Benzo withdraw sometimes cause neuropathy in just ONE limb?  If so, could increasing my dose slightly or stabilizing for a while reverse it?  I'm worried it's something more serious such as stroke, MS, or ALS which are all known to affect just one limb or one side of the body.

 

The weakness feels like lifting heavy weights until the muscles are completely fatigued.  The clumsiness feels like being out in the cold without gloves until the fingers become slow and stiff.  After a full night of rest the arm and hand feel fairly good, but simple movements cause fatigue quickly.  It's an awkward feeling that's difficult to describe - the limb feels heavy, sluggish, and I drop things often as I reach for them.  Sometimes the small fingers become more sensitive to touch and warmth, but rarely do I get the classic pins and needles.  I can't easily use the hand now, but part of that could be anxiety driven.

 

Two days before this began I had the worst headache of my life with a 100 deg-F fever, but both were gone in less than 24 hours.  I'm early 40's with normal blood pressure and great health, but I suppose I could have had a stroke.

 

I also have a very mild ruptured disc and a slightly dessicated disc in my neck at C5-6 and C6-7, but the EMG supposedly ruled out compression of the nerve roots, and I have no arm or shoulder pain.

[[me...]]

Hi CRF250R,

 

The types of symptoms you mention are actually common in withdrawal. The following is from The Ashton Manual:

 

 

Muscle symptoms. Benzodiazepines are efficient muscle relaxants and are used clinically for spastic conditions ranging from spinal cord disease or injury to the excruciating muscle spasms of tetanus or rabies. It is therefore not surprising that their discontinuation after long-term use is associated with a rebound increase in muscle tension. This rebound accounts for many of the symptoms observed in benzodiazepine withdrawal. Muscle stiffness affecting the limbs, back, neck and jaw are commonly reported, and the constant muscle tension probably accounts for the muscle pains which have a similar distribution. Headaches are usually of the "tension headache" type, due to contraction of muscles at the back of the neck, scalp and forehead - often described as a "tight band around the head". Pain in the jaw and teeth is probably due to involuntary jaw clenching, which often occurs unconsciously during sleep.

 

At the same time, the nerves to the muscles are hyperexcitable, leading to tremor, tics, jerks, spasm and twitching, and jumping at the smallest stimulus. All this constant activity contributes to a feeling of fatigue and weakness ("jelly-legs"). In addition, the muscles, especially the small muscles of the eye, are not well co-ordinated, which may lead to blurred or double vision or even eyelid spasms (blepharospasm).

 

None of these symptoms is harmful, and they need not be a cause of worry once they are understood. The muscle pain and stiffness is actually little different from what is regarded as normal after an unaccustomed bout of exercise, and would be positively expected, even by a well-trained athlete, after running a marathon.

 

There are many measures that will alleviate these symptoms, such as muscle stretching exercises as taught in most gyms, moderate exercise, hot baths, massage and general relaxation exercises. Such measures may give only temporary relief at first, but if practised regularly can speed the recovery of normal muscle tone - which will eventually occur spontaneously.

 

Bodily sensations. All sorts of strange tinglings, pins and needles, patches of numbness, feelings of electric shocks, sensations of hot and cold, itching, and deep burning pain are not uncommon during benzodiazepine withdrawal. It is difficult to give an exact explanation for these sensations but, like motor nerves, the sensory nerves, along with their connections in the spinal cord and brain, become hyperexcitable during withdrawal. It is possible that sensory receptors in skin and muscle, and in the tissue sheaths around bones, may fire off impulses chaotically in response to stimuli that do not normally affect them.

 

In my clinic, nerve conduction studies in patients with such symptoms revealed nothing abnormal - for example, there was no evidence of peripheral neuritis. However, the symptoms were sometimes enough to puzzle neurologists. Three patients with a combination of numbness, muscle spasms and double vision were diagnosed as having multiple sclerosis. This diagnosis, and all the symptoms, disappeared soon after the patients stopped their benzodiazepines.

 

Thus these sensory symptoms, though disconcerting, are usually nothing to worry about. Very occasionally, they may persist (see section on protracted symptoms). Meanwhile, the same measures suggested under muscle symptoms (above) can do much to alleviate them, and they usually disappear after withdrawal.

 

[[ge...]]

It's normal to have symptoms prevalent on one side of the body more than the other. For me, it's always been the left side.

[[CR...]]

Thanks Megan918 and GettingThere!

 

The article was very interesting.  I was surprised to read that these withdraw symptoms have been misdiagnosed as MS!  What a terrible thing to hear for someone already suffering withdraw.  I've never had the tight, spastic, or sore muscles they describe, but some of the symptoms are similar.

 

It's reassuring to hear that GettingThere has also experienced one-sided symptoms.  But I'm still on high anxiety alert, half convinced I have something more serious.  The article doesn't discuss symptoms so selective that they only strike one hand or arm.

 

Have others on this forum experienced distressing neuropathy that only affected a single body part?  And has anyone experienced one sided muscle atrophy?  Muscles don't waste away unless the nerve supply is cutoff.  My symptoms are nearly identical to the early onset of ALS, but the odds for that are extremely low.

 

Thanks for your support!

[[Ja...]]

You say that you have a "very mild ruptured disc". Unless I'm missing something, there is no,such thing. A very mild bulging disc, sure. But if it's ruptured in that tiny space, it could well be causing your arm problems. If only bulging, probably not. Has a doc evaluated your neck?

 

I have hand and arm atrophy, weakness ans weird sensations. I know the atrophy is neck related, I have severe stenosis at c5-7, but the other stuff is a mix of wd and neck, I think.

[[sh...]]

Thanks Megan 918 your post kinda answered a lot of the questions I had about some new symptoms I've been getting, reassurance I needed right now 

[[ea...]]

JackStraw has a good point. However, it sounds like you have had quite a neuro workup and have seen your doctor recently.

I had many different muscle symptoms....cramps, jerks, twitches, pain, weakness. The only thing I still have are these incredibly painful cramps of fingers and toes. For a while, I had severe hand pain but only at night. My doctor felt it could be carpal tunnel syndrome. Well, it just went away, quite suddenly. Guess it wasn't carpal tunnel, huh? I am still amazed at the variety and scope of benzo withdrawal symptoms. Every single part of our bodies can be affected. But, unlike "normal" diseases, in benzo w/d, one really does heal. It just may take time, and all your patience, but you will heal.

east

[[CR...]]

When I had my neck MRI last May I wasn't having muscle weakness or atrophy, just neck stiffness.  The symptoms appeared August 14, then on August 26 the neurologists said my EMG and nerve conduction results were normal and that he didn't see any evidence of a pinched nerve root in my neck, arm, or elsewhere.

 

I'm having a difficult time typing.  I used to be a concert jazz pianist, so I immediately noticed a major problem when I sat down to play 4 weeks ago.

 

Can this really be Benzo withdraw?  I don't see how such a select group of acetylcholine and GABA neurotransmitters could be affected such that I'm having a problem primarily along my right arm Ulnar nerve, and possibly the right Median and Radial nerves too.  Occasionally I feel pain in my elbow near the Ulnar nerve (Cubital Tunnel), but the neurologist ruled that out.

 

I'm worried this isn't going to go away, and feel I'd rather be dead than to live without the use of my hand and arm.  It's such a strange, heavy, unpleasant feeling.  So I think about having the arm amputated if it doesn't get better. Maybe that's anxiety, but it's how I feel.

 

These are the May 2014 MRI findings:

C4-5-C6: mild uncovertebral spurring bilaterally with very mild posterior bulging of intervertebral discs. No focal disc herniation. No central canal stenosis or neural foraminal stenosis.

C6-C7: Mild uncovertebral spurring present. There is also a small disc extrusion extending cephalad in the midline, along the posterior aspect of the C5 vertebral body. These nears the anterior cord. There is narrowing of the CSF space anterior to the cord without significant canal stenosis. No neaural foraminal stenosis.

[[ea...]]

All I can tell you is that for me, it did turn out to be withdrawal. Nearly ALL my symptoms, both mental and physical, have gone now. I still cannot sleep, but that's not surprising for someone who took benzos AND drank for 30 years!

I have a couple weird remaining symptoms but I can live with them...not worth getting ujpset over such smallish things.

It took me months to start to accept that it was withdrawal. Months! I was sure BB was wrong, perhaps a little crazy, and was sure I had some awful disease. Because I am a nurse, I took each symptom and compared it to symptoms of various diseases. I was too paranoid to see doctors, however - and in retrospect, this was a good thing...for me, anyway. I DO have some serious medical problems, yes. A couple are directly a result of my long term benzo use. A couple are a result of major surgery I had years ago. I have to lie with these things, and I cannot make them disappear. But I can assure you that all the other stuff I had WAS withdrawal, pure and simple. As a nurse, I gave thousands of benzo pills to my patients....thousands. I was never told, or taught, how dangerous they CAN be. I thought they were basically harmless, unless you overdosed. I knew alcohol was dangerous, but not my benzos. So I continued to take them happily able to sleep like a darn baby. Now I know better...at least for me, they are not good drugs. I know that many people take them and get off them without trouble but I am not one of those lucky people. I can never take benzos again. They would kill me, and I fought too hard to get through w/d to risk it again.

I would suggest reading all the good and learned articles about benzo withdrawal - on this site, and on other sites. This might help you start to fully understand, and more important, to accept...that your symptoms very well could be from benzos.

I am not a doctor, obviously, and not trained to read MRI results, but reading yours I did NOT feel there was anything horribly wrong with your spine. Of course, spines change, things happen. Things can go wrong. But it sounds as if you have been seeing your doctors regularly, and you kind of have to trust that they would have spotted something amiss.

east

[[Ka...]]

I am experiencing the same thing as you. I thought I had MS or ALS. I've had the nerve conduction study done, the emg, 2 MRI's, and tons of blood work. All was normal.

 

I've had it all on my right side. I've had the weak, fatigued arm feeling, the pins and needles in my hand and fingers, and stiff neck and shoulder pain. I finally figured out it was the lorazepam in July. My health anxiety made the symptoms worse. I notice that when I don't think about it, the symptoms are mild and don't bother me like hey used to. I notice the lower I go in my taper, the better my arm feels.

 

Don't stress. It makes it worse. If your tests came back normal, then you are fine. It's just the benzo.

[[CR...]]

Kate, it's reassuring to hear that you have symptoms in just one limb.  Most posts describe symptoms as in BOTH legs, or fully systemic throughout the entire body.  Since all your tests came back normal you must be experiencing withdraw symptoms.  My arm symptoms didn't start until 4 weeks ago, almost 6 months after I started tapering, and I never had tolerance symptoms.  For the arm I've only had nerve conduction and EMG tests, and also the neck MRI several months earlier.  I'm seeing a doctor next week that specializes in Physical Medicine of the spine, muscles, and nerves.  Since this came on quickly after the worst headache of my life and the symptoms are opposite the side of the headache, I hope they can still check for stroke or Meningitis after 4 weeks.  I'd also like to get tested for ALS and MS just in case.  And maybe they can more closely check the nerves around my neck and upper arm.  After all that I'll know it is the Benzos if all tests are normal.

 

Eastcoast, my doctor and neurologist do not think my spine is causing the problem either.  But my neck muscles are extremely tight and painful, which I've learned here is a common benzo WD symptom.  Chronic tight neck muscles are also a common symptom of cervical spine problems - the body trying to prevent further damage by locking the neck in.

 

If I'm experiencing Benzo withdraw, I'm surprised it took 6 months of tapering before any symptoms appeared.

[[...]]

I've been tapering off 2 mg/day Clonazapam for the last 7 months, and now take 0.75 mg/day.

 

Four weeks ago I suddenly developed weakness and clumsiness in my right hand, and noticed mild atrophy in the palm muscle that abducts the pinky. The weakness is mostly limited to functions of the Ulnar nerve, but I've had weird sensations throughout the entire arm the would also include the Median and Radial nerves.  The neurologist and orthopedic hand doctor couldn't find anything wrong with the hand, and my nerve condition and EMG tests were normal.  Even so I'm having a difficult time typing this.

 

Does Benzo withdraw sometimes cause neuropathy in just ONE limb?  If so, could increasing my dose slightly or stabilizing for a while reverse it?  I'm worried it's something more serious such as stroke, MS, or ALS which are all known to affect just one limb or one side of the body.

 

The weakness feels like lifting heavy weights until the muscles are completely fatigued.  The clumsiness feels like being out in the cold without gloves until the fingers become slow and stiff.  After a full night of rest the arm and hand feel fairly good, but simple movements cause fatigue quickly.  It's an awkward feeling that's difficult to describe - the limb feels heavy, sluggish, and I drop things often as I reach for them.  Sometimes the small fingers become more sensitive to touch and warmth, but rarely do I get the classic pins and needles.  I can't easily use the hand now, but part of that could be anxiety driven.

 

Two days before this began I had the worst headache of my life with a 100 deg-F fever, but both were gone in less than 24 hours.  I'm early 40's with normal blood pressure and great health, but I suppose I could have had a stroke.

 

I also have a very mild ruptured disc and a slightly dessicated disc in my neck at C5-6 and C6-7, but the EMG supposedly ruled out compression of the nerve roots, and I have no arm or shoulder pain.

 

hey buddy i´m experiencing the same but in left hand.... exactly how u describe it, and with tremor in fingers.

also my scapula is affected...with atrophy. also fear of something more serious, but neuro tests gone OK........

i know this post is old, but i´d appreciate any comment or info u can share about your hand symptom.

 

greetings from argentina

[[ba...]]

As many folks have noted (as well as Dr. Ashton), tapering can bring on an amazing range of aches/pains and just plain weird sensations. While of course it's possible we can contract 'real' afflictions, I've read of sooo many people having tons of expensive and/or invasive tests, only to eventually conclude whatever the problem was, ended up being a result of our darn CNS starting to fire up and flip out after weeks/months/years of being 'buffered' or muffled by benzos.

 

Since I began tapering, I feel like I've aged decades with a host of mostly physical 'suffering,' but I'm looking forward to some day being free of much of that dratted crap. It's hard not to panic, and imagine all sorts of awful diseases and conditions; I'm trying to stay calm(ISH!), and keep on plugging and staying as active as possible. We all gotta tough it out, for the most part 

[[bl...]]

Wow, I'm having the same problem. Just searching on here and came across this. My right and and right leg. When I take a muscle relaxer it seems to help a bit. I CT 21 days ago and a couple days after this started. Is it normal at this time frame still? .50mg xanax daily I was on.

[[Ge...]]

As difficult as your symptoms are, I also feel confident that it is a result of benzo withdrawal. I'm not a doctor but I'm in withdrawal myself, have done extensive studying, an shown doctors my loooong list of symptoms. I get it, that it is easy to catastrophize. My advice is to take reassurance that several doctors have reviewed your case and they are apparently not concerned that it's something "bad." Try to stay grounded, mindful, and enjoy the moment. You've got this!

[[bl...]]

As difficult as your symptoms are, I also feel confident that it is a result of benzo withdrawal. I'm not a doctor but I'm in withdrawal myself, have done extensive studying, an shown doctors my loooong list of symptoms. I get it, that it is easy to catastrophize. My advice is to take reassurance that several doctors have reviewed your case and they are apparently not concerned that it's something "bad." Try to stay grounded, mindful, and enjoy the moment. You've got this!

 

I go to a neurologist Tuesday.  Today the right arm is bothering me again. Wrist area and forearm. Feels warm, heavy, tired, and kinda like its fallen asleep from laying on it. Sometimes a slight very slight ache too.

 

I also have those internal tremors too all over my body. Neurologist will think its ms or something. Im so nervous about this. Yesterday my arm felt pretty good.  Not today.

[[bl...]]

Today was using my arm a lot but it didn't bother me much today! Still felt a very tad of fatigue, especially around the wrist and a tiny bit tingly like when you're using the computer all day but overall not that bad at all. Still having some inner tremors but not that bad.

 

Hopefully things are turning around. Still have the neurologist appointment tuesday which I'll go to. Have a separate issue with a pec muscle injury pressing on a nerve at times so it won't be a total waste of time.