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World’s hottest pepper may have triggered this man’s severe headaches

Known as the Carolina Reaper, the chili can constrict arteries in the brain

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6:44pm, April 9, 2018
Carolina Reaper

FEAR THE REAPER  The Carolina Reaper (shown) has a rating of more than 2 million Scoville heat units — a measure of spiciness —making it the hottest pepper in the world, according to Guinness World Records. In contrast, the jalapeño has a rating up to 8,000 units.

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Hot peppers aren’t just a pain in the mouth — they may be a pain in the head, too. After eating the hottest known pepper in the world, a man suffered from splitting headaches that drove him to the hospital emergency room, and into case-study history.

His is the first known instance of reversible cerebral vasoconstriction syndrome — a temporary narrowing of arteries in the brain — to be tied to eating a hot pepper, researchers report April 9 in British Medical Journal Case Reports. Such narrowed arteries can lead to severe pain called “thunderclap headaches” and are often associated with pregnancy complications or illicit drug use.

During a hot-pepper-eating contest, the man ate a chili dubbed the Carolina Reaper, named by Guinness World Records as the hottest pepper in the world. The Carolina Reaper is over 200 times as spicy as a jalapeño. About a minute later, he reported experiencing splitting headaches that came and went over two days before he sought treatment.

Initial tests failed to find anything out of the ordinary. But a CT scan of blood vessels in the man’s brain showed severely narrowed arteries. After treatment, including hydration and pain medication, the headaches stopped. When the researchers imaged his brain five weeks later, the arteries had returned to their normal size.

What a headache

After eating a very spicy pepper, a man had severely narrowed arteries in his brain (arrows at left) and pounding headaches. When researchers looked again five weeks later, the arteries had returned to normal size (right).

Given the immediate onset of symptoms after eating the chili, it’s likely that capsaicin, a main ingredient in hot peppers, was responsible for the headaches, says study coauthor Kulothungan Gunasekaran, an internal medicine expert at Henry Ford Hospital in Detroit. Capsaicin, a known irritant, is used in pepper sprays, but in smaller doses it can relieve pain. Two previous studies have connected cayenne peppers with heart troubles, including a nonfatal heart attack.

Gathering more data to better understand how capsaicin affects the brain could be tricky. The problem, Gunasekaran says, is that such a case is “a very rare occurrence. And no one’s willing to volunteer to eat this Carolina Reaper to see.”

Well, almost no one.

Citations

S.K. Boddhula et al. An unusual cause of thunderclap headache after eating the hottest pepper in the world — “The Carolina Reaper.” British Medical Journal Case Reports. Published online April 9, 2018. doi: 10.1136/bcr-2017- 224085. 

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