Ketamine: Is It Pro-Epileptic or Anti-Epileptic? The Debate Continues. A Narrative Review with a Case Discussion

Ketamine is one of the old anaesthetic agents which has regained popularity in analgesia, trauma, emergency medicine, neurology and psychiatry. Recently several cases were reported on ketamine induced seizures in otherwise healthy children despite its popularity in the treatment of refractory status epilepticus. We present an eight-year-old prematurely born healthy boy who developed two episodes of generalized tonic clonic seizures following administration of ketamine for a short ophthalmic procedure. This case and our comprehensive narrative review of literature on pro- and anti-epileptic effects of ketamine show that the debate continues and gaps on mechanism of action, etiology and risk factors for ketamine’s epileptic activity remains. Due to the recent increase in its use further evaluation on ketamine’s epileptic effects is warranted to ensure safe and effective use of ketamine.