HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

What Causes Lack Of Concentration, Stiffness And Unsteady Hand?

Posted on Sat, 4 Jul 2015

Question: I'm 27 year old I've been on many antidepressants and antipsychotics before also drinkink alcohol.. Now iam being treated by a neurologist with clonazepam & bio d3 XXXXXXX & my complain is that my left hand becomes rigid, unsteady & clumsy wen playin guitar & my mind Dnt connect to anything I Dnt have the clarity, mood emotions, or feelings its as if only the intellect part of me is left wen asked the Dr only says dat its no big prob den nothin, so I want to know my condition at least

Answered by Dr. Ajay Panwar (1 hour later)

Brief Answer:
Needs to be seen.

Detailed Answer:
Hi XXXX,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.

Dear friend,I am concerned for you but at the same time I am afraid to say that your clumsy and rigid hand needs to be seen while playing a guitar as you said that playing a guitar precipitates the rigidity and clumsiness in the hand.
Clinical conditions like musician's cramp or a task specific dystonia needs to be ruled out.Is it possible for you to create a short video clip of yourself playing guitar,while focussing on your hand?If yes,please upload it here,for me to make a true impression.

Does your hand remains completely normal while not playing the guitar?

Regarding yourself don't having clarity,mood emotions or feelings-the nature of this problem is not apparently neurological.Please consult a psychiatrist regarding this and he will surely be able to help you.

Waiting for your follow up query.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ajay Panwar (12 hours later)

I made the video but I get an error message saying it can upload only pdf jpg jpeg tif png tiff

My problems were intrusive thoughts & social anxiety but after I was put on antipsychotic at the same time drinkin I developed some apathy, slowness decresed awareness in short I became dysfunctional & I also noticed my fingers were moving so I stopped drinking & the medicine as well then I began to greatly improve overtime but I noticed my fingers weren't making some move I intended on guitar so I went to a neurologist he prescribed elavil & prodep I took a drink while on meds then all the problems that I described to you earlier started, so its not my mental illness is it? was it an injury? i'm confused.. I also experienced some serious headache and weakness
Later & it was as tough my mind began to shut down

At rest my I notice my hands seem to have a mild tension always & while resting at the guitar neck without pressing any note I have tremors also had a test which showed left arm & pinky had lower strengh

Answered by Dr. Ajay Panwar (5 hours later)

Brief Answer:
Drug induced expyramidal effect.

Detailed Answer:
Hi XXXX,
Thanks for being in follow-up.

With your further clinical history,it appears to be extrapyramidal effect of drugs(like antipsychotics and Prodep) which has taken its toll on your left hand.

It should improve with gradually after stopping the offending medicines.
However,lower strength in left arm and hand needs to be documented.Which test confirmed it?It needs to be confirmed on neurological examination because its not fitting into the clinical picture.

Meanwhile,please upload the video on google drive and share the link here in the follow-up query,so that I may answer your query in a better way.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ajay Panwar (20 hours later)

Yes it was a confirmed by a test of which I forgot the name but they attaced a device to arm, hand and send electricity to measure the strengh

https://drive.google.com/file/d/0000

I was on meganeuron od & clonazepam for 3 months & now on bio d3 XXXXXXX & clonazepam by the neurologist can you shade some light on why iam on this meds & was the clonazepam prescribed for the tremors & anxiety? Is it safe for longterm use?

Sorry I actually meant eliwel 10 mg and prodep 20 mg not elavil

Answered by Dr. Ajay Panwar (4 hours later)

Brief Answer:
Clonazepam is for anxiety tremors.

Detailed Answer:
Hi XXXX,
Thanks for being in follow-up again and uploading the video.

I have gone through the video uploaded.Your left hand seems to have some kind of focal dystonic movements in this video.
I suggest you to continue clonazepam as it will take care of anxiety tremors and possibly the dystonic posturing also(though it may not improve dystonic movements in some cases).Continuing clonazepam appears to be the best approach here as the diagnosis is not confirmed and we have to go for a therapeutic trial.

I would like you to continue clonazepam for few days and keep in follow-up.I am interested in tracking your clinical course.

Clonazepam does not have much side effects in clinical practice.However,it should be tapered and stopped,once a stable response is achieved.

Hope that I have answered your query.If you have some follow up questions,I shall be glad to answer else please close the thread,rate it and write a review as your rating will be of help to me.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar