Cameron-Burr Keaton, Terry-Kantor Elizabeth, Wilson Taneshia
Brown University, Department of Emergency Medicine, Providence, Rhode Island.
Clin Pract Cases Emerg Med. 2025 May;9(2):169-172. doi: 10.5811/cpcem.24830.
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.
矛盾性声带运动（PVCM）是一种主要的神经精神疾病，可导致呼吸时声带不适当内收。这种疾病常被误诊并当作难治性哮喘或需要重症监护病房级护理的上气道梗阻来治疗。最近的专家意见表明，给予氯胺酮可能促进PVCM症状缓解；然而，这一现象尚未在文献中得到记载。
这是一名23岁女性的病例，她因急性PVCM加重而就诊于急诊科（ED）。在对包括苯二氮䓬类药物在内的标准治疗方法无反应后，给该患者静脉注射亚麻醉剂量的氯胺酮，这导致症状缓解并出院。
亚麻醉剂量的氯胺酮可能是急诊科治疗PVCM加重的一种安全有效的疗法。在本报告中，我们探讨了可能介导该病例临床结果的患者因素。
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