Doctors treated a man for severe “thunderclap” headaches apparently triggered by eating a “Carolina Reaper,” the world’s hottest chilli pepper.

The bizarre incident, spotlighted in the journal BMJ Case Reports, resulted from the unidentified young man’s participation in a hot chilli pepper eating contest. The pain was so excruciating, he ended up in emergency care, doctors reported.

His symptoms started immediately after he had eaten the chilli, with dry heaves. But over the next several days, he developed severe neck pain and crushingly painful episodic headaches, each of which lasted just a few seconds.

A CT (computed tomography) scan showed several arteries in his brain had constricted, prompting doctors to diagnose him with a condition known as thunderclap headache secondary to reversible cerebral vasoconstriction syndrome (RCVS).

RCVS occurs when blood vessels in the brain narrow, causing severe headache pain. Studies have shown it can develop as a reaction to certain prescription meds, or after taking illegal drugs.

The new case is believed to be the first reported incident tied to eating chilli peppers, but doctors note cayenne pepper has been linked to sudden constriction of the coronary artery and even heart attacks in rare cases.

“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,” write the authors.

The man’s symptoms cleared up on their own.