© Dale Thurber /Wikimedia CommonsThe Carolina Reaper, recognized as the world’s hottest pepper.
The unusual case, detailed in The BMJ on Monday, began immediately after the 34-year-old man took part in a chili pepper eating contest. He ate a Carolina Reaper, the pepper christened as the world's hottest by the Guinness Book of World Records in 2013 (though there have been several unofficial challengers to the title since).
Immediately after eating the pepper, he started dry heaving. Then he felt excruciating neck pain that soon radiated throughout his entire head. For the next several days, he would experience short but incredibly painful bursts of head pain known as thunderclap headaches. The episodes got so bad that he eventually visited the ER.
Thankfully, a brain scan didn't reveal any major neurological issues, such as a bulged blood vessel (aneurysm) or bleeding. But several of his arteries did appear to narrow significantly, a condition called reversible cerebral vasoconstriction syndrome (RCVS).
RCVS is known to cause thunderclap headaches, and can be brought on by reactions to drugs, including cocaine and certain antidepressants. No case of RCVS has ever been associated with pepper-eating, but the main ingredient that accounts for a pepper's spiciness-capsaicin-is known to interact with our blood vessels, either by constricting or dilating them, the doctors noted. And cayenne peppers have been rarely linked to heart attacks or suddenly constricted arteries near the heart.
© Salil Sharma/Gregory Cummings(A) CT angiography showing unexpected luminal narrowing in the left supraclinoid internal carotid artery, M1 segment of bilateral middle cerebral arteries, and P1 segments of bilateral posterior cerebral arteries consistent with vasospasm. (B) CT angiography showing resolution of luminal narrowing after 5 weeks of supportive care.
As its name implies, RCVS typically goes away on its own within days to weeks. The man was given supportive care, and eventually his headaches disappeared completely. A brain scan taken five weeks later revealed that his arteries returned to their normal size with no lingering issues.
Medical oddity aside, these record-setting peppers aren't typically dangerous, save to the pride of anyone who thinks they can easily take them on. Still, the doctors hope their report might help others confronted with a similarly mysterious case of unexplained headaches.
Reference:
"An unusual cause of thunderclap headache after eating the hottest pepper in the world - 'The Carolina Reaper'" - BMJ Case Reports 2018; doi:10.1136/bcr-2017-224085
I have never thrown up or had migraines from eating a reaper.
One time, I wanted to die after eating what was touted as the "world's hottest pizza," but I didn't throw up or have a migraine. I did feel every millimeter of flesh inside of me that came in contact with that pizza, and did not sleep that night, but I survived. And that pizza had reapers, scorpions, habaneros, paper lanterns, scotch bonnets and other super-hots pureed into a sauce and then was topped with the same peppers.
I seriously doubt his thunderclap migraine was caused by the reaper itself. Also, he is a wimp.