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Carolina Reaper pepper causes thunderclap headache, doctors say

Headache came from constricted brain artery
Image: Carolina reaper pepper
Ed Currie holds three Carolina Reaper peppers. The hot peppers may have caused a man's "thunderclap" headache, doctors say.Jeffrey Collins / AP file

The Carolina Reaper is the stuff of internet legend, from ghastly YouTube videos to testimonials in gourmet cooking magazines.

Now this pepper, billed as the world’s hottest, has made it into a medical journal.

Eating this fiery pepper can cause a “thunderclap” headache, doctors reported Monday. The headache was the result of an unusual blood vessel condition called reversible cerebral vasoconstriction syndrome (RCVS), doctors reported in the British Medical Journal’s Case Reports.

They described the case of a 34-year-old man who ate a Carolina Reaper hot pepper in a contest.

“His symptoms began with dry heaves but no vomiting immediately after participation in a hot pepper contest where he ate one ‘Carolina Reaper,’ the hottest chili pepper in the world,” Dr. Kulothungan Gunasekaran of the Bassett Medical Center in Cooperstown, New York, and colleagues wrote.

“Then he developed an intense headache,” they added. “The pain was excruciating and thus he came to the ER.”

Thunderclap headaches are severe headaches and come on very fast. They can be a sign of a brain hemorrhage or a stroke, so doctors take them very seriously.

Brain scans showed the pepper-eater wasn’t suffering from a stroke, but a major artery in his brain had narrowed.

The medical team diagnosed RCVS.

That’s never been diagnosed after eating hot peppers before, but Turkish doctors have reported a heart attack in a young man who took cayenne pepper pills.

Hot peppers deliver capsaicin, the compound that gives them their “heat.” It can affect blood vessels.

“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,’” Gunasekaran and colleagues wrote.

“Treatment is observation and removal of the offending agent.”

The patient recovered and had a normal brain scan five weeks later.

Eating hot peppers can cause people to vomit and can lead to severe heartburn but the pain is rarely serious. Capsaicin can, in some cases, relieve pain and may help people keep weight off.