Successful Treatment of Paradoxical Vocal Cord Motion with Sub-dissociative Dose Ketamine: Case Report.
Keaton T Cameron-Burr, Elizabeth Terry-Kantor, Taneshia Wilson
Clinical Practice and Cases in Emergency Medicine May 1, 2025 DOI: 10.5811/cpcem.24830 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | 23-year-old female with acute PVCM exacerbation |
| Interventions | Intravenous sub-dissociative dose ketamine |
| Dose | sub-dissociative dose |
| Topics | Esketamine Ketamine |
| Keywords | Ketamine-therapy Respiratory-medicine Breakthrough-treatments Rare-diseases Vocal-cord-disorders |
| Citations | 1 |
| Key findings | Sub-dissociative dose ketamine resolved symptoms in a PVCM patient who did not respond to benzodiazepines. |
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.