Síndrome opsoclonus-mioclonus secundario a intoxicación por duloxetina

espanolIntroduccion El sindrome opsoclonus-mioclonus es una entidad poco frecuente, de origen autoinmune y que puede aparecer a cualquier edad, siendo mucho mas frecuente en la edad pediatrica. Su etiologia es muy diversa, frecuentemente paraneoplasica o de origen infeccioso. Los casos secundarios a intoxicacion por drogas o medicamentos son infrecuentes. Caso clinico Mujer de 43 anos valorada por Psiquiatria de Enlace por sobreingesta de 80 comprimidos de duloxetina 30mg. Acude a Urgencias por un cuadro de inicio brusco de vision borrosa, temblor generalizado, dificultad para caminar y alucinaciones visuales. Ingresa en Neurologia por sospecha de sindrome opsoclonus-mioclonus, recibe tratamiento esteroideo precoz, tras el que se observa mejoria clinica y recuperacion temprana. Las pruebas complementarias resultan normales, excepto los niveles de duloxetina, que estan muy por encima del rango normal. Discusion El sindrome opsoclonus-mioclonus es un trastorno del movimiento infrecuente, que requiere una correcta evaluacion debido a la posibilidad de estar relacionado con neoplasias subyacentes. EnglishIntroduction Opsoclonus-myoclonus syndrome is a rare entity of autoimmune origin, which can appear at any age, being much more common in paediatric patients. Its aetiology is very diverse, often of para-neoplastic or of infectious origin. Cases secondary to poisoning by drugs or other kind of medication are uncommon. Clinical case A 43 year-old woman was examined by Liaison Psychiatry due to an overdose of 80 tablets of duloxetine 30mg. The patient went to the Emergency Service due to a sudden onset of blurred vision, general tremor, difficulty to walk, and visual hallucinations. She was admitted to the Neurology Department due to a clinical suspicion of opsoclonus-myoclonus syndrome. She received early steroid treatment, after which both clinical improvement and early recovery were observed. Complementary tests were normal except for duloxetine levels, which were found to be well above their normal range. Discussion Opsoclonus-myoclonus syndrome is an uncommon disorder, which requires a correct diagnostic evaluation and analysis, as it could possibly be related to underlying neoplasms.