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BMJ Case Reports 2018; doi:10.1136/bcr-2017-224085
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An unusual cause of thunderclap headache after eating the hottest pepper in the world – “The Carolina Reaper”

Press Release
  1. Edward Bischof2
  1. 1 Internal Medicine, Bassett Medical Center, Cooperstown, New York, USA
  2. 2 Bassett Medical Center, Cooperstown, New York, USA
  3. 3 Henry Ford Health System, Detroit, Michigan, USA
  1. Correspondence to Dr Kulothungan Gunasekaran, stankuloth{at}gmail.com
  • Accepted 28 February 2018
  • Published 9 April 2018

Description

A 34-year-old man with no significant medical history presented to the emergency room (ER) 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 ER. He denied any focal tingling sensation or weakness, slurred speech, or transient loss of vision. Physical examination revealed blood pressure of 134/69 mm Hg and …

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