Successful Treatment of Paradoxical Vocal Cord Motion with Sub-dissociative Dose Ketamine: Case Report.
Clinical practice and cases in emergency medicine – May 01, 2025
Source: PubMed
Summary
A rare vocal cord condition that mimics severe asthma found an unexpected solution: low-dose ketamine. When a 23-year-old woman's vocal cords inappropriately constricted during breathing, standard treatments failed to help. Doctors tried a small dose of ketamine, which quickly resolved her symptoms. This breakthrough suggests ketamine could offer fast relief for similar cases, avoiding intensive care stays and misdiagnosis.
Abstract
Paradoxical vocal cord motion (PVCM) is a primarily neuropsychiatric condition that causes inappropriate adduction of the vocal cords during respiration. This condition is commonly misdiagnosed and treated as refractory asthma or upper airway obstruction requiring intensive care unit-level of care. Recent expert opinion suggests that ketamine administration may promote PVCM symptom resolution; however, this phenomenon has not yet been documented in the literature. This is the case of a 23-year-old female who presented to the emergency department (ED) with acute PVCM exacerbation. After failing to respond to standard-of-care therapies including benzodiazepines, the patient was administered intravenous, sub-dissociative dose ketamine, which led to symptom resolution and discharge. Sub-dissociative dose ketamine may be a safe and effective therapy for PVCM exacerbations in the ED. In this report we explore the patient factors that likely mediated the clinical outcome in this case.