Eating a California Reaper – the world’s hottest chilli pepper – proved to be a mistake for a young American who ended up hospitalised with thunderclap headaches

The 34-year-old man ate the pepper during a hot pepper eating contest, and immediately became ill with dry heaves but no vomiting, the authors of a paper published in the BMJ write.

He then began to experience severe neck pain and “crushingly-painful” headaches, each of which lasted a few seconds, over the span of several days.

The man’s pain was so severe that he presented to the emergency room, where he was tested for a number of neurological conditions. All of these results came back negative.

A CT scan showed that several arteries in his brain had constricted, and the doctors diagnosed him with thunderclap headache secondary to reversible cerebral vasoconstriction syndrome (RCVS).

“RCVS is characterised by multifocal cerebral arterial constriction that resolves within days to weeks and often presents with a thunderclap headache,” the authors write.

“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.

“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.’

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

The man’s symptoms resolved on their own and a CT scan five weeks later showed that his affected arteries had returned to their normal width.