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January 8, 1988

Horseradish Horrors: Sushi Syncope

Author Affiliations

Montefiore Hospital Bronx, NY

Montefiore Hospital Bronx, NY

JAMA. 1988;259(2):218-219. doi:10.1001/jama.1988.03720020020024

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To the Editor.  —Chinese restaurant syndrome is well described in the medical literature; most symptoms pertaining to this disorder are, however, more of a "headache" than a true threat to life or well-being. In contrast, I would like to report a case of near-catastrophe related to an uninitiated diner eating in a Japanese restaurant.

Report of a Case.  —A 63-year-old previously healthy man decided to dine with his wife and friends at a Japanese restaurant; he had never before partaken of sushi served with a mound of wasabi—a mixture of horseradish. The first morsel of sushi swallowed was therefore not the expected raw fish, but rather consisted of the entire mound of wasabi. The effects were as immediate as they were devastating: he became pale, diaphoretic, and confused; he staggered from the restaurant and collapsed on the sidewalk. Though the night was cool, he rapidly diaphoresed a large quantity of