Ketamine is a noncompetitive N-methyl-_D-aspartate antagonist with emerging evidence for use in medically refractory epilepsy. We describe the novel use of low-dose intravenous (IV) ketamine transitioning to enteral formulation in a patient with drug-resistant localization-related refractory epilepsy. We performed a National Library of Medicine (NLM) literature review using search terms “ketamine”, “low dose”, and “seizure” for similar cases, followed by an illustrative clinical case. Our NLM search engine methodology yielded 24 hits, none of which described use of low-dose ketamine for seizures. Anesthetic doses are used for status epilepticus, but we show that in a patient with postoperative worsening of his chronic seizure burden, low-dose IV ketamine can be used to avoid oversedation and intubation. We demonstrate that IV ketamine can be transitioned to oral regimen to shorten length of stay in the intensive care unit and hospital and has future CYP2B6 pharmacogenomic considerations for further dose individualization.

氯胺酮是一种非竞争性的N-甲基_-D-天冬氨酸拮抗剂，具有在医学上难治性癫痫中使用的新证据。我们描述了低剂量静脉内（IV）氯胺酮过渡到肠溶性患者耐药耐药性顽固性癫痫患者的新型用途。对于相似的病例，我们使用搜索词“氯胺酮”，“低剂量”和“癫痫发作”进行了国家医学图书馆（NLM）文献综述，然后进行了示例性临床病例研究。我们的NLM搜索引擎方法产生了24次匹配，均未描述使用小剂量氯胺酮进行癫痫发作。麻醉剂量可用于癫痫持续状态，但我们表明，对于慢性癫痫发作负担加重的术后患者，低剂量静脉注射氯胺酮可用于避免过度镇静和插管。