Have a patient who has had a recent head injury? Do you suspect a post-concussion syndrome?
Concussion symptoms generally resolve quickly in most patients. Often it will only take a few days for the symptoms to subside, but in a handful of patients, the symptoms can linger for months.
Some of the most common symptoms include headache, neck pain, and insomnia. These usually resolve first. Unfortunately, fatigue tends to be the major symptom that likes to linger around for a prolonged period of time though.
To treat the physical symptoms, over the counter medications such as ibuprofen and Benadryl will help with the headaches and sleep. Sometimes you need to prescribe something stronger for sleep such as hydroxyzine or Ambien, but usually 25-50mg of Benadryl does the trick.
Fatigue on the other hand can be difficult to treat. The fatigue can be very bothersome in high functioning patients, therefore a reasonable approach to treating the fatigue that a top neurologist in my area recommends for post-concussion patients is modafinil. This medication typically will boost energy without the adverse effects of stimulants. Additionally, it does not tend to increase blood pressure or heart rate at any significant level.
Be cautious though, as this medication can develop dependency, therefore only use this for a short period of time and provide adequate patient education.