4 months post pontine stroke in a previously healthy 44yr old male. orgasm causes severe neck pain, nausea and dizziness lasting 2-4 hours.

Bothersome: The major question is the cause of your stroke, as there is risk of another(unless it was of traumatic origin, such as vertebral dissection). Your description refers to a migraine-like reaction, which may be due to neurochemical glutamine sensitivity in the area of damage, and perhaps a migraine preventative will quell the reaction. But get this totally defined, even a second opinion.

Worrisome: So the stroke victim is apparently not you. Something about this case smells to me like the stroke was due to a top-of-the-basilar occlusion or basilar artery dissection or both. My advice is to lay off the whoopee pending a thorough reassessment by a neurologist including possibly repeat imaging studies viz. MRI and MRA.