Ketamine for acute management of refractory stiff person syndrome: a case report.
BMC neurology April 9, 2025 Evan Eggiman, William Kerr, Brandon Spivey et al.
A 22-year-old man with Stiff Person Syndrome, an autoimmune neurological disorder causing progressive muscle rigidity and painful spasms, experienced acute symptom exacerbation unrelieved by high-dose benzodiazepines, baclofen, and intravenous methocarbamol. Treatment with intravenous ketamine produced rapid and significant symptom resolution. Although recurrent flares required repeated ketamine administration, it remained consistently effective when standard treatments failed. The patient's care was complicated by anxiety, hypoxia, and venous thromboembolism. Ketamine's antagonism of NMDA receptors and enhancement of GABAergic signaling may underlie its benefit, suggesting it as a potential second-line treatment for refractory SPS exacerbations.