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Resumen Introduccion 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 30 mg. 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.

OBJECTIVE The aim of this study was to analyze the potential association between personality traits and onabotulinumtoxin A (onabotA) response in patients with chronic migraine (CM). BACKGROUND Previous studies from a categorial perspective show that patients with CM have anxious or obsessive personality according to the Salamanca screening test. However, the influence of personality traits in onabotA response in patients with CM has not yet been studied. We hypothesize that cluster C personality traits may be associated with non-response to onabotA. METHODS This case-control observational study includes patients with CM who received at least 2 treatment cycles of onabotA in 2 headache units between January and May 2018. onabotA response was defined as a reduction of at least 50% in the number of monthly migraine days. Personality traits were evaluated using the Salamanca questionnaire, a validated categorial inventory assessing 11 personality traits. RESULTS One hundred and twelve patients, 100/112 (89.6%) females, mean age (standard deviation): 43 (11) years, were recruited. 96/112 (85.7%) achieved response to onabotA. Dependent trait was significantly associated with non-response to onabotA (P = .008; OR: 0.223 [95%CI: 0.074 to 0.675]). Significant association with other personality traits or confounders was not found. CONCLUSIONS To the best of our knowledge, this is the first study showing personality traits may predict onabotA response in patients with CM. The presence of dependent personality trait in patients with CM is associated with non-response to onabotA.