Thunderclap headaches are so named because they make you feel like your cranium has been struck with the force of a thunderstorm. Their dramatic, debilitating pain strikes without a warning and can last for several minutes, often without any obvious trigger — at least, most of the time. Other times, a new BMJ Case Reports study reveals, a very specific and very spicy trigger can be the culprit: the Carolina Reaper chili pepper.

The Carolina Reaper is the hottest chili pepper in the world, measuring in at two million Scoville heat units. For comparison, a spicy habanero might be closer to 500,000 Scoville units. The notorious pepper is the center of a study released Monday, which describes a 34-year old man who recently checked into Bassett Medical Center in Cooperstown, New York with intense neck and head pain — aka the thunderclap headache. He didn’t know what was wrong with him, but doctors did have a pretty good clue: The man had recently participated in a hot pepper eating contest.

carolina reaper, brain
CT angiography showing the narrowing of the patient's carotid artery, 

In this contest, the man consumed the infamous Carolina Reaper — the pepper most likely to make wannabe YouTube stars cry online. After gobbling up what the pepper’s cultivator, Ed Currie, describes as “kind of like eating molten lava,” the patient immediately began dry heaving. Over the next several days, he developed the painful headaches, each lasting a few seconds, and eventually checked himself into emergency care.

Tests for neurological conditions came back negative, so the doctors analyzed his brain with a computed tomography scan. This revealed that several arteries in his brain had constricted, and the doctors diagnosed him with thunderclap headaches secondary to reversible cerebral vasoconstriction syndrome (RCVS), which is characterized by temporary artery narrowing and often accompanies thunderclap headaches. “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,” the authors write.

The marriage of thunderclap headaches and RCVS has previously been documented in cases of illegal drugs or bad reactions to prescription meds, but this is the first case where it’s tied to eating chili peppers. Cayenne pepper has been previously linked to the constriction of the coronary artery and heart attacks — and the Carolina Reaper is much spicier. The pepper was bred to be packed full of compounds called capsaicinoids that, when they encounter mucous membranes, send signals to your nerve cells that make your mouth feel like it’s literally on fire.

Despite the calamity that befell this dude, the doctors behind the study told the New York Times that they’re “not advising anything against the Carolina Reaper.” If you do eat one and it proves to be too spicy, Currie recommends slurping down some citric acid and to avoid milk, unless you’re looking to take a trip to vom city.