An overview of visual snow syndrome: migraines

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Visual snow syndrome is a unique disorder in which you have persistent visual impairment, usually in the form of tiny, flashing, continuous, "snow" or "static" dots across your field of vision (similar to what you can see when watch an old television). These dots are usually black and white, but they can flicker, be colored, or even transparent. Although it was once thought to be a form of migraine , scientific research confirms that this syndrome is a unique and distinct condition .

No one knows how many people have visual snow syndrome because it is a fairly new diagnosis, but it seems quite unusual – there are only about 200 documented cases worldwide .

Illustration by Emily Roberts, Get Drug Information

Symptoms

Most people with visual snow syndrome see these little dots in both eyes all the time. The condition may worsen after prolonged screen viewing or during severe stress.

Visual symptoms

Along with persistent snowfall, there may be other visual symptoms that lead to vision loss, such as :

  • Floats
  • Flashes of light
  • Impaired night vision
  • Colored curls
  • Preservation of the visual image, even though it is removed from the field of vision.
  • Sensitivity to light ( photophobia )

Non-visual symptoms

There may also be other symptoms that are not visual, including :

  • Migraine
  • Tinnitus (ringing in the ears)
  • Dizziness (feeling dizzy)
  • Fatigue
  • Shaking
  • Anxiety
  • Depression

Migraine is an especially noteworthy symptom. A 2014 study of 120 patients with visible snow found that 70 of them also suffered from migraines, and 37 of them had a typical migraine aura .

Migraines have exacerbated some of the symptoms of visual snow syndrome, especially vision when the image disappears, photosensitivity, altered night vision, spontaneous flashes of light, and tinnitus. The migraine aura has also been associated with spontaneous flashes of light in the field of vision.

However, it is important to remember that while many people with visual snow syndrome have migraines with or without aura , the syndrome itself is not a migraine .

Causes

Scientists don't know exactly what causes visual snow syndrome, but it appears to be a complex neurological disorder. Studies have shown that people with this syndrome have a brain abnormality in the lingual gyrus, a structure at the back of the brain in the occipital lobe .

Because the visual pathways converge in the occipital lobe, experts suspect that an abnormality in vision processing is the mechanism underlying visual snow syndrome. In particular, nerve cells in the brain of people with visual snow syndrome can overreact to visual stimuli. These highly sensitive nerve cells mistakenly send signals to the brain, which interprets them as real images.

Diagnostics

Your healthcare provider will review your medical history, perform a physical exam, refer you for an eye exam or a referral, and perform a neurological exam to rule out other conditions.

Once ruled out, visual snow syndrome is diagnosed if you see visual or static snow continuously for more than three months, plus two or more of the following:

  • Sensitivity to light (photophobia)
  • Impaired night vision (nyctalopia)
  • See an image of an object even though it is no longer there (palinópsia)
  • Other visual changes, such as the vision of floating objects.

History of misdiagnosis

In the past, people with visual snow syndrome were often misdiagnosed as migraines, psychogenic disorder (pain with a psychological basis), or post-hallucinogenic memories.

However, the vast majority of people with visual snow syndrome have not abused drugs and their visual symptoms do not improve with traditional migraine treatments. Also, most people with visual snow syndrome have normal test results.

While advances in understanding visual snow syndrome have led to a more precise definition, consider getting a second opinion if you think you may have had the condition but have been diagnosed differently.

Watch out

Medical professionals do not yet know how to treat this unique condition. A report from a patient with this syndrome in 2015 found that the anticonvulsant drug lamictal (lamotrigine) effectively relieves symptoms. Lamictal has also helped reduce the number of migraine attacks per month.

Another 2018 report describes visual snow syndrome in a 47-year-old man after a car accident. He was successfully treated with a low dose of a tricyclic antidepressant called amitriptyline, but again, this was a single patient study.

Research with more patients is needed to determine which treatments work best.

Get the word of drug information

If you suspect you have visual snow syndrome, make sure your doctor checks it out. Scientists now know that this syndrome is not a variant of migraine, it is associated with a specific part of the brain. We hope this stimulates research on the best way to treat this very real but rare condition.

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