World's hottest chilli causes thunderclap headaches

The ability to eat a hot chilli pepper has often been treated as a lighthearted test of resilience.

But a 34-year-old man taking part in a hot chilli pepper eating contest in the US suffered unexpected — and painful — consequences after eating a ‘Carolina Reaper’, the world’s hottest chilli pepper.

Reported on in the journal BMJ Case Reports, the man ended up in emergency care with excruciatingly painful episodic headaches after eating the chilli pepper.

His symptoms started immediately after he had eaten the chilli, with dry heaves. But he then developed severe neck pain and crushingly painful headaches, each of which lasted just a few seconds, over the next several days.

His pain was so severe that he sought emergency care and was tested for various neurological conditions, the results of which all came back negative.

But a CT (computed tomography) scan showed that several arteries in his brain had constricted, prompting doctors to diagnose him with thunderclap headache secondary to reversible cerebral vasoconstriction syndrome (RCVS).

RCVS is characterised by temporary artery narrowing often accompanied by thunderclap headache. It doesn’t always have an obvious cause, but can occur as a reaction to certain prescription meds, or after taking illegal drugs.

This is the first case to be associated with eating chilli peppers, explained the authors, although they pointed out that eating cayenne pepper has been linked to sudden constriction of the coronary artery and heart attacks.

“Given the development of symptoms immediately after exposure to a known vasoactive substance, it is plausible that our patient had RCVS secondary to the Carolina Reaper,” the authors wrote.

The man’s symptoms cleared up by themselves. And a CT scan 5 weeks later showed that his affected arteries had returned to their normal width.

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