僵硬的人综合症（SPS）是一种罕见的自身免疫性疾病，其特征是极度疼痛的肌肉痉挛，刚度,和整个身体的刚性。它的稀有性通常转化为患者有限的治疗选择，偶尔,获得明确诊断的挑战。SPS还会影响患者的心理健康，社会和经济参与，和整体生活质量。一名43岁的男子最初因腰椎神经根痛而被发现。由神经科医生做出SPS的临床诊断，并通过临床随访和抗谷氨酸脱羧酶（抗GAD）抗体测试证实。疼痛管理医生同意这一诊断，并提供静脉（IV）氯胺酮治疗，他发现这对类似疾病的治疗有积极影响。在最初的10天输注后，患者报告疼痛和功能改善.近两年来,患者接受静脉注射免疫球蛋白(IVIg)和静脉注射氯胺酮治疗,以控制病情,维持疼痛控制和生活质量.当患者的症状在IVIg输注后开始恶化时，决定退出IVIg输注并继续输注氯胺酮。在停止IVIg输注后，患者报告功能和疼痛水平有所改善,并继续每月接受2天的氯胺酮辅助治疗.除了输液之外，患者能够停止使用芬太尼贴剂并继续服用氯胺酮锭剂，羟考酮-对乙酰氨基酚，和右美沙芬用于家庭疼痛管理。患者的症状继续有效地管理与他们目前的治疗方案，使他们能够重返工作岗位，并提高生活质量。该案例说明了静脉氯胺酮治疗对治疗耐药SPS和类似神经系统和自身免疫性疾病患者的潜在益处。了解和检查罕见综合征的治疗替代方案对于实现最佳患者预后至关重要。此外,记录这些案例提供了对氯胺酮机制的宝贵见解，超越这些综合症。
Stiff Person Syndrome (SPS) is a rare autoimmune condition marked by extremely painful muscle spasms, stiffness, and rigidity throughout the body. Its rarity often translates to limited treatment options for patients and, occasionally, challenges in obtaining a definitive diagnosis. SPS also impacts patients\' mental health, social and economic involvement, and overall quality of life. A 43-year-old man was initially being seen for lumbar radicular pain. A clinical diagnosis of SPS was made by a neurologist and confirmed by in-clinic follow-ups and anti-glutamic acid decarboxylase (anti-GAD) antibody testing. The Pain Management doctor agreed with this diagnosis and offered intravenous (IV) ketamine treatment, which he has found to positively impact the treatment of similar disorders. After an initial 10-day infusion, the patient reported improvement in pain and function. For almost two years, the patient received intravenous immunoglobulin (IVIg) and IV ketamine treatments to manage their condition and maintain pain control as well as quality of life. When the patient\'s symptoms began worsening after IVIg infusions, the decision to withdraw IVIg infusions and continue ketamine infusions was made. After discontinuing IVIg infusions, the patient reported improvement in function and pain level and continues to receive monthly two-day ketamine boosters. Outside of the infusions, the patient was able to discontinue the use of fentanyl patches and continued taking ketamine lozenges, oxycodone-acetaminophen, and dextromethorphan for at-home pain management. The patient\'s symptoms continue to be managed effectively with their current regimen, enabling their return to work and experiencing an enhanced quality of life. This case illustrates the potential benefits of IV ketamine treatment for patients with treatment-resistant SPS and similar neurologic and autoimmune disorders. Understanding and examining treatment alternatives for rare syndromes is crucial for achieving optimal patient outcomes. Additionally, documenting such cases offers valuable insights into the mechanism of ketamine, extending beyond these syndromes.
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