Mystery Solved: The Cause of Iceberger's Syndrome

True to form, OmniBrain has posted an informative video about the "ice cream headache" also known as "Iceberger's syndrome." This is the nominally painful headache one experiences after eating too much of something extremely cold. While no "silent killer," as the video jokingly claims, "brain freeze" is actually a real thing (sphenopalatine ganglioneuralgia) with a perfectly reasonable cause.

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When you consume something very cold like ice cream or a 40 oz Slushie, it rapidly chills the roof of your mouth (the hard palate). Just above the hard palate is the sphenopalatine nerve which is extremely sensitive to rapid changes in temperature. As the cold food cools the hard palate, it stimulates the sphenopalatine nerve, "tricking" the brain into thinking that you are in an extremely cold environment. And, the body's reaction to suddenly being in a very cold place is to constrict the blood vessels in the brain, reducing blood flow to the brain. The pain is actually caused by the subsequent influx of warm blood which then forces the vessels open. Since the pain is actually felt in the head, rather than the roof of your mouth, the pain is "referred."

However, Iceberger's syndrome has a cure! Just warm the hard palate by placing your tongue on it. This will reduce the stimulation on the nerve behind it and reduce the stricture of the cerebral blood vessels.

(Note: I thought it might also be from cooling the blood traveling to the brain via the vessel sitting close to the throat.

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Thank you for your comment, Calli Arcale. I tried to research this show but no luck. Something similar happened to my friend. He drank 3 frozen margaritas FAST. Next thing i know, he's on the ground, hit his head and eyes rolled back. after about 15 seconds, he came to. It was sooo scary. I have researched ice cream headaches, brain freeze and sphenopalatine ganglioneuralgia. Cant find a single thing about this ever happening to anyone else. Does anyone know someone this has happened to?? thanks. lunachick0075 at yahoo.

There's also a much more exciting cure! One that was indicated in a link in one of your previous posts: Drill a hole into your forehead.

Ah, the chance to speak about one of my favorite journal articles of all time!…
E.G. Boring's "The sensations of the alimentary canal" (1915, The American Journal of Psychology) was the first systematic examination of, well, the sensations of the alimentary canal. Using stimuli specially designed to vary temperature (a bulb that could be filled with liquid at a known temperature, constantly circulating to maintain that temp), mechanical stimulation (an inflatable bulb), electrical stimulation (just what it sounds like) and chemical stimulation (precise releases of known dilutions of alcohol, hydrochloric acid, mustard, pepper, and peppermint), the researchers (Boring and his student volunteers) tested various distances down the throat for each stimulus set. Essentially, the group had to learn to deep-throat the apparatus (a particularly squidgy section of the paper deals with how some would be fine with swallowing, but not with withdrawal, and so would choose to keep the apparatus in their throat during breaks in the experiment). They tested (essentially gathering introspective reports) the esophagus from the mouth to the stomach... then started up the other end of the alimentary canal with roughly the same equipment.

Along with finding out that an infusion of peppermint at a particular point in the colon leads to a "call to defecate", they found the area of the esophagus responsible for the "ice cream headache".

Ah, the early days of experimental psychology! Back when researchers were researchers, tools were brass and walnut, CAT or PET scans were yet unimagined, and one could write a classic research paper about shoving things down your throat or up your bum.

Ain't science wonderful!!

I haven't tried this and I see no way that it could possibly work, but one time when I was eating out at a local buffet I saw the guy at the next table just dusting the hell out of a plate of ice cream with black pepper. After watching the guy for a while I started talking to him and he swore up and down that the black pepper kept him from getting brain freeze AND that it didn't alter the taste of his icecream. Like I said, I don't see how this would actually prevent brain freeze and I also don't see how literally coating the top of your ice cream with black pepper could NOT alter the taste but this guy was wolfing it down like it was nothing.

The nasopalatine (aka long sphenopalatine) nerves run along either side of the nasal septum, superior to the hard palate, and enter the oral cavity and mucosa of the hard palate via the incisive foramen. So, if that's the nerve responsible for ice cream headache, there's no delay required for the frozen food to cool the hard palate-there are nerve endings in the palate mucosa itself. The nasopalatine nerve innervates the mucosa of the hard palate just posterior to the maxillary incisor teeth (corresponds to the embryonic "premaxilla", or primary palate), so it would be most efficient to warm up that region specifically with your tongue, if you're trying to alleviate the pain.

The pain is referred to the head because the nasopalatine nerve is a branch of the maxillary division of CN V, which also innervates the meninges and walls of large blood vessels in the cranial cavity. "Sphenopalatine ganglioneuralgia" is kind of a misleading name, IMO, because the nociceptive/thermoceptive afferents in the nasopalatine nerve have their cell bodies in the trigeminal ganglion, not in the sphenopalatine (aka pterygopalatine) ganglion, which is parasympathetic.

Sorry, I'm tetchy about cranial nerve anatomy. ;-)

"but one time when I was eating out at a local buffet I saw the guy at the next table just dusting the hell out of a plate of ice cream with black pepper."

Out of curiosity... was this guy absurdly obese?

By John Shmitty (not verified) on 07 Jan 2008 #permalink

He wasn't obese, but let's just say he wasn't athletic either.

My wife has a fibrous dysplasia of bone in her clivus (the part of the skull where the optic nerves and carotid artery go in), which can lead to nasty migraines. We serendipitously discovered (while she was waiting for surgery on it) that an ice cream headache could actually give her relief from those.

The pain is actually caused by the subsequent influx of warm blood which then forces the vessels open. Since the pain is actually felt in the head, rather than the roof of your mouth, the pain is "referred."

I watched the video over at Omni Brain. It was interesting. Thanks for the technical info. Whatever the cause, I think it is safe to say that once in a lifetime is more than enough! LOL! Ouch!!!
Dave Briggs :~)

By Dave Briggs (not verified) on 07 Jan 2008 #permalink

I was watching one of those real-life ER shows on Discovery Health (possibly True Stories of the ER, but I don't recall for sure) when they showed a guy who suffered from an extreme and potentially life-threatening variation on the ice cream headache. He was admitted to the ER after having inexplicably passed out shortly before. This wasn't the first time it had happened, but doctors had never been able to find anything wrong with the guy. Well, this time it happened again in the ER itself, and the wife had a brain flash -- the one thing in common with the episodes at home was that she'd just given her husband a glass of ice water to drink. They got the guy wired up to monitors and everything and did an experiment: gave him ice water to drink. Bam, he passed out immediately, but safely in a hospital bed and with plenty of staff around to revive him. His vital signs dropped alarmingly when it happened -- blood pressure was shockingly low, and his pulse slowed way down. Then, seconds later, he came right back to normal as if nothing had happened. They concluded that he had a particularly drastic version of an ice cream headache. Prescription was to avoid ice-cold drinks or foods.

By Calli Arcale (not verified) on 09 Jan 2008 #permalink