[27F] With headache, neck stiffness, and leg weakness

Patient Description

A 27-year-old female has been experiencing a headache for a week, described as aching and sometimes throbbing, with an intensity of 5 out of 10. The headache worsens with activities such as walking, sitting, and doing chores, and is accompanied by sensitivity to light and nausea. Additionally, she reports neck stiffness and pain upon pressure, as well as knee pain when walking. There is also weakness and numbness in the legs, affecting balance and coordination. The patient has a history of complex partial seizures diagnosed in 2015 and bipolar disorder type 2 diagnosed in 2021. She is currently taking carbamazepine and levetiracetam for seizures and stopped taking aripiprazole for bipolar disorder two months ago. No recent injuries, infections, or lifestyle changes have been noted, and there are no known medication allergies.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, several conditions could be contributing to your discomfort:

  1. Migraine or Tension Headache: Your headache, which is aching and sometimes throbbing, along with sensitivity to light, could be indicative of a migraine or tension-type headache. Migraines can also cause nausea and are often worsened by physical activity.

  2. Medication Side Effects or Withdrawal: Since you recently stopped taking aripiprazole, it's possible that some of your symptoms, such as headache, nausea, and concentration difficulties, could be related to withdrawal effects or adjustments in your body's response to the change in medication.

  3. Cervical Strain or Tension: The stiffness and pain in your neck, along with the headache, could be related to muscle tension or strain in the cervical region. This can sometimes cause referred pain to the head and contribute to headaches.

  4. Neurological Concerns: Given your history of seizures and the new onset of leg weakness and balance issues, it's important to consider neurological causes. These symptoms could be related to your seizure disorder or another neurological condition.

What you can do

Headache and Nausea:

  • Try to rest in a dark, quiet room to minimize light sensitivity and reduce headache intensity.
  • Stay hydrated and consider over-the-counter pain relief, such as acetaminophen or ibuprofen, if appropriate and not contraindicated by your current medications.
  • Keep a headache diary using MDandMe to track triggers, frequency, and severity, which can be helpful for your healthcare provider.

Neck and Back Pain:

  • Apply a warm compress or heating pad to your neck and back to help relax tense muscles.
  • Gentle stretching exercises for the neck and back may help alleviate stiffness.
  • Avoid activities that exacerbate the pain and consider ergonomic adjustments to your workspace or posture.

Knee Pain:

  • Rest your knee and avoid activities that worsen the pain.
  • Consider using a knee brace or support if needed for stability.
  • Ice the knee for 15-20 minutes several times a day to reduce inflammation.

General Advice:

  • Since you have a history of seizures and are experiencing new neurological symptoms, it's important to consult with your healthcare provider to rule out any serious underlying conditions.
  • Use MDandMe to journal your symptoms, track progress, and share insights with your healthcare provider.

What you should look out for

Seek medical attention promptly if you experience any of the following:

  • Severe or worsening headache, especially if accompanied by visual changes or neurological symptoms like confusion or difficulty speaking.
  • Persistent or worsening leg weakness or balance issues.
  • Any new or unusual symptoms related to your seizure disorder.

Remember, while I can provide information and suggestions, it's important to consult with a healthcare professional for a formal diagnosis and appropriate treatment.

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2 mo ago

People Also Ask


What are the common symptoms of a migraine and how can they be managed?

Common symptoms of a migraine include a throbbing headache, sensitivity to light and sound, nausea, and sometimes vomiting. Management can include resting in a dark, quiet room, staying hydrated, and using over-the-counter pain relief like acetaminophen or ibuprofen. Keeping a headache diary can also help identify triggers.


Can stopping aripiprazole cause withdrawal symptoms, and what might they include?

Yes, stopping aripiprazole can cause withdrawal symptoms, which may include headache, nausea, dizziness, irritability, and difficulty concentrating. It's important to consult with a healthcare provider before stopping any medication to manage withdrawal symptoms effectively.


How can neck stiffness and pain be alleviated at home?

Neck stiffness and pain can be alleviated by applying a warm compress or heating pad to the affected area, performing gentle stretching exercises, and avoiding activities that worsen the pain. Ergonomic adjustments to your workspace or posture can also help.


What should I do if I experience new neurological symptoms like leg weakness and balance issues?

If you experience new neurological symptoms like leg weakness and balance issues, it's important to consult with a healthcare provider promptly. These symptoms could indicate a serious underlying condition, especially given a history of seizures, and require professional evaluation.


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