The 34-year-old had consumed just one 'Carolina Reaper' in an eating contest when he immediately felt intense head and neck pain before suffering from splitting headachesc

A man who ate the world's hottest chilli pepper was later rushed to hospital with excruciating "thunderclap" headaches.

The 34-year-old had consumed just one 'Carolina Reaper' in an eating contest when he immediately felt intense head and neck pain.

Over the next few days he was struck with short splitting headaches lasting seconds at a time and was taken to hospital when the pains became unbearable.

Medical experts said it was the first ever recorded case of a chilli causing these types of headaches.

Dr Kilothungan Gunasekaran at the Department of Internal Medicine, Bassett Medical Center, New York, explained: "A 34-year-old man with no significant medical history presented to the emergency room after an episode of thunderclap headache.

"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.

"He then developed intense neck and occipital head pain that became holocephalic.

"During the next few days, on at least two occasions and in retrospect he thought probably more often, he experienced brief intense thunderclap headaches lasting seconds.

"The pain was excruciating and thus he came to the emergency room."

The patient told doctors he did not have any focal tingling sensation or weakness, slurred speech, or transient loss of vision.

And his had slightly high blood pressure of 134/69mm Hg.

Tests for various neurological conditions came back negative until scans revealed several arteries in his brain had constricted.

This prompted US 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

Dr Gunasekaran added: "RCVS is characterised by multifocal cerebral arterial constriction that resolves within days to weeks and often presents with a thunderclap headache.

"It can occur without an identifiable cause, as an idiosyncratic reaction to certain medications (ergotamine, selective serotonin reuptake inhibitors, alpha– sympathomimetic decongestants, and triptans), or secondary to an illicit drug (cocaine, amphetamines, and ecstasy).

"No cases of RCVS secondary to peppers or cayenne have been previously reported, but ingestion of cayenne pepper has been associated with coronary vasospasm and acute myocardial infarction.

The man's symptoms cleared up by themselves and a CT scan five weeks later showed his affected arteries had returned to their normal width.

Dr Gunasekaran said: "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.'"

He added the case had implications for doctors presented with a similar unusual patient.

RCVS should be considered as a potential cause of thunderclap headache after most common causes are ruled out including subarachnoid haemorrhage, cerebral vein thrombosis, and cervical artery dissection.

It should also be considered if the patient has thunderclap headaches and admits they are a "chilli head."

The study was published in the journal BMJ Case Reports.

Posted Date : April 11, 2018
Ref : Mirror

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