[22M] Experiencing prolonged headache, neck stiffness, and general malaise

Patient Description

A 22-year-old male reports a persistent headache with throbbing pain behind the right eye, exacerbated by neck movement. The headache has lasted for three days and is accompanied by neck stiffness, which has been present for a week and is worse in the morning. The patient also experiences general weakness, akin to flu-like symptoms without a fever, and has difficulty sleeping. There is a slight sensitivity to light and some difficulty concentrating, along with a change in attitude. The patient has been taking Atomoxetine 40 mg for ADHD for three months and has no known allergies or adverse reactions to medications. There is no recent history of injury, recreational drug use, or pre-existing conditions. The patient has received meningitis vaccinations.

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Arora's Assessment

What might be happening

Based on your symptoms, here are a few possibilities:

  • Tension Headache: This is a common type of headache that can cause a constant ache and tightness around your forehead or at the back of your head and neck. It's often described as a band-like pressure or a weight on top of the head. These headaches are often related to stress, poor posture, or not getting enough rest.

    • Treatment typically involves over-the-counter pain relievers like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin IB). Lifestyle modifications such as regular physical activity, healthy meals, staying hydrated, and adequate sleep can also help.
  • Migraine: This is a type of headache characterized by throbbing pain, usually on one side of the head, that worsens with movement. It can also cause sensitivity to light and sound. However, migraines are typically associated with other symptoms like nausea and vomiting, which you did not report.

    • Treatment for migraines often includes a combination of medications and lifestyle changes like avoiding known triggers.
  • Viral Illness: Your general feeling of weakness and flu-like symptoms could be due to a viral illness. While you don't have a fever, not all viral illnesses cause a fever.

    • Treatment usually involves rest, hydration, and over-the-counter medications to manage symptoms.
  • Side Effects of Atomoxetine: Atomoxetine can cause side effects such as headache, tiredness, and difficulty sleeping. However, it's less likely since you've been on the medication for 3 months without prior issues.

What you can do

  1. Try over-the-counter pain relievers like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin IB) for your headache and neck stiffness. Follow the instructions on the package for proper dosage.
  2. Make sure you're getting enough rest, staying hydrated, and eating healthy meals.
  3. Try to identify any potential triggers for your headaches, such as stress or certain foods, and avoid them if possible.
  4. If your symptoms persist or worsen, make an appointment to see your doctor. They may want to adjust your Atomoxetine dosage or try a different medication.

What you should look out for

Seek immediate medical attention if you experience:

  • A sudden, severe headache like a thunderclap
  • Headache with fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness or speaking difficulties
  • Headache after a head injury, especially if the headache worsens
  • A chronic headache that is worse after coughing, exertion, straining or a sudden movement

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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11 mo ago

People Also Ask


What are the common symptoms of a tension headache?

Common symptoms of a tension headache include a constant ache and tightness around the forehead or at the back of the head and neck, often described as a band-like pressure or a weight on top of the head. It can be related to stress, poor posture, or lack of rest.


Can Atomoxetine cause headaches or other side effects?

Yes, Atomoxetine can cause side effects such as headache, tiredness, and difficulty sleeping. However, these side effects are less likely to occur if you have been on the medication for a while without prior issues.


What lifestyle changes can help manage headaches?

Lifestyle changes that can help manage headaches include regular physical activity, maintaining a healthy diet, staying hydrated, getting adequate sleep, and identifying and avoiding potential headache triggers such as stress or certain foods.


When should I seek immediate medical attention for a headache?

You should seek immediate medical attention for a headache if you experience a sudden, severe headache like a thunderclap, headache with fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness, or speaking difficulties, or if the headache occurs after a head injury and worsens.


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