Long-term relief of CRPS-associated limb dystonia with ketamine infusion

Complex regional pain syndrome (CRPS) with associated dystonia is a severely debilitating condition often refractory to conventional management. We present a case report of three patients with chronic, treatment-refractory CRPS-related limb dystonia. Patients were treated with multiday intravenous ketamine infusions (target dose 30 mg/hour) every 3-6 months, supplemented with oral ketamine troches. This treatment protocol resulted in the complete resolution of dystonia in two patients and significant functional improvement in the third. The treatment was well-tolerated, with transient and manageable adverse events including nausea and hypertension. While these findings are limited due to the small sample size and lack of randomisation, this case report presents a potentially promising therapeutic approach for the treatment of CRPS-related motor complications in carefully selected patients with appropriate monitoring.