Abstract: We report the successful use of low‐dose ketamine infusion for treating a severe episode of painful myoclonus in the lower extremities, associated with opioid‐induced hyperalgesia (OIH), in a patient who was receiving long‐term, high dose intrathecal hydromorphone therapy. A low‐dose ketamine infusion immediately relieved the painful myoclonus. It also enabled a reduction in the intrathecal opioid dosage leading to a resolution of the acute symptoms attributed to OIH.
