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Successful Treatment of Functional Neurologic Symptom Disorder (Conversion Disorder) With Subdissociative Dose Ketamine in the Emergency Department.

Anna R Kimata, Keaton T Cameron-Burr, Taneisha Wilson

Journal of the American College of Emergency Physicians Open October 1, 2025 DOI: 10.1016/j.acepjo.2025.100220 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Case study Case report Peer reviewed
Sample size 1
Population 28-year-old male with acute functional neurologic disorder in the emergency department
Intervention Intravenous subdissociative dose ketamine
Dose subdissociative dose
Topics Ketamine Esketamine
Keywords Fnd Conversion disorder Functional neurologic disorder Ketamine intervention Treatment Emergency department care
Citations 1
Key findings Subdissociative dose ketamine rapidly resolved symptoms in a patient with acute functional neurologic disorder refractory to standard treatment.

Abstract

Functional neurologic disorder (FND) is a neuropsychiatric condition that causes psychosomatic symptoms-commonly pain, paralysis, and seizure-like activity. Because presentation can be relatively heterogeneous with symptoms that overlap with other life-threatening or disabling neurologic disorders, FND is often misdiagnosed and incorrectly managed. This results in inappropriate resource utilization and patient care, including but not limited to unnecessary hospital admissions, procedures, imaging resource use, and radiation exposure. Effective treatment of FND often includes a combination of psychotherapy and medication. This is the case of a 28-year-old male who was transferred to a regional level 1 trauma center with concern for acute traumatic spinal cord injury after a fall. Following a negative evaluation for traumatic spinal cord injury and other red flag diagnoses, the patient was diagnosed with FND. The patient's symptomatology was refractory to treatment with nonsteroidal anti-inflammatory medications and benzodiazepines. The patient was administered intravenous subdissociative dose ketamine, after which rapid symptom resolution and discharge were achieved. Subdissociative dose ketamine may be a safe, effective, and efficient therapy for FND exacerbations in the emergency department. The patient factors that mediate the clinical outcome require further exploration.

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Electroconvulsive Therapy, Ketamine, and Esketamine in a Patient with Major Depressive Disorder and Multiple Comorbidities: A Case Report over 10-year Treatment from Adolescence to Adulthood. A patient with treatment-resistant depression and comorbid generalized anxiety... 2025 Case report n = 1
Treatment of compulsive behaviour in eating disorders with intermittent ketamine infusions Chronic and treatment-resistant eating disorder patients 1998 Case series n = 15
Oral Administration of the NMDA Receptor Antagonist S-Ketamine as Add-On Therapy of Depression: A Case Series Four depressed patients taking standard antidepressants 2009 Case series n = 4
A longitudinal case series of IM ketamine for patients with severe and enduring eating disorders and comorbid treatment‐resistant depression Patients with enduring eating disorders and treatment-resistant depression 2021 Case series n = 4

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