Visual snow syndrome

Silvia Cherninkova; T. Angelov

Authors

Silvia Cherninkova UMHAT "Alexandrovska"
T. Angelov UMHAT "Alexandrovska"; Medical university – Sofia

Keywords:

Visual snow syndrome, case reports

Abstract

Visual snow syndrome (VSS) is a rare clinical condition characterized by persistent positive visual phenomena in both eyes – multiple flickering small dots involving the entire visual field. VSS is predominantly observed at a young age, with onset most often in the third decade. The females are more commonly affected. The pathophysiology of the syndrome is unclear. The neurological and ophthalmological examination, as well as imaging studies of the brain are normal.
In the present publication, we present 5 patients (3 males and 2 females, mean age at examination 23,8 ± 7,08 years) with a clinical diagnosis of VSS. The average age of onset of their complaints (appearance of „permanent shining and flickering spots” in the entire vision field, simultaneously in both eyes, is 17,0 ± 8,09 years. In all patients, the neuro-ophthalmological status, including best corrected visual acuity, biomicroscopy of the anterior segment of the eye, tonometry, ophthalmoscopy, assessment of oculomotor movements, and at discretion, optical coherence tomography (OCT), etc. are normal. The magnetic resonance imaging of the brain, performed in all patients, as well as electroencephalography demonstrate normal finding. The clinical condition of the patients is monitored dynamically.

References

Adcock, J., Panayiotopoulos, C. Occipital lobe seizures and epilepsies. J Clin Neurophysiol, 2012, 29, 397-407.

Bessero, A., Plant, G. Should ‘visual snow’ and persistence of after-images be recognised as a new visual syndrome? J Neurol Neurosurg. Psychiatry, 2014, 85, 1057-1058.

Bou Ghannam, A., Pelak, V. Visual snow: a potential cortical hyperexcitability syndrome. Curr Treat Options Neurol, 2017, 19, 9.

Cho, S., Sohn, J., Bae, J., Chu, M. Fibromyalgia among patients with chronic migraine and chronic tension-type headache: a multicenter prospective cross-sectional study. Headache, 2017, 57, 10, 1583-1592.

Eren, O., Rauschel, V., Ruscheweyh, R., Straube, A., Schankin, C. Evidence of dysfunction in the visual association cortex in visual snow syndrome. Ann Neurol. 2018, 84, 6, 946-949.

Fraser, C., Hepschke, J., Jenkins, B., Prasad, S. Migraine Aura: Pathophysiology, Mimics, and Treatment Options. Seminars Neurol, 2019, 39, 739-748.

Graber, M., Goadsby, P., Scutelnic, A., Schankin, C. Natural course of Visual Snow Syndrome: a long-term follow-up study. Eur J Neurol, 2020, 27, Suppl. 1, 103-522, 162.

Guay, M., Lagman-Bartolome, A. Onset of Visual Snow Syndrome After First Migraine Episode in a Pediatric Patient: A Case Report and Review of Literature. Pediatric Neurology, 2021.

Halpern, J., Pope, H. Jr. Hallucinogen persisting perception disorder: what do we know after 50 years? Drug Alcohol Depend, 2003, 69, 109-119.

Hang, C., Leishangthem, L., Yan, Y. Not All Cases of Visual Snows are Benign: Mimics of Visual Snow Syndrome. Neuropsychiatric Disease and Treatment, 2021, 17, 3293-3300.

Hermle, L., Simon, M., Ruchsow, M., Geppert, M. Hallucinogenpersisting perception disorder. Ther Adv Psychopharmacol, 2012, 2, 199-205.

Klein, A., Schankin, C. Visual Snow Syndrome as a Network Disorder: A Systematic Review. Front Neurol, 2021, 12, 724072.

Lauschke, J., Plant, G., Fraser, C. Visual snow: a thalamocortical dysrhythmia of the visual pathway? J Clin Neurosci, 2016, 28, 123-127.

Levi, L., Miller, N. Visual illusions associated with previous drug abuse. J Clin Neuroophthalmol, 1990, 10, 103-110.

Liu, G., Schatz, N., Galetta, S., Volpe, N., Skobieranda, F., Kosmorsky, G. Persistent positive visual phenomena in migraine. Neurology, 1995, 45, 664-668.

Mehta, D., Garza, I., Robertson, C. Two hundred and forty-eight cases of visual snow: a review of potential inciting events and contributing comorbidities. Cephalalgia, 2021, 41, 9, 1015-1026.

Piquet AL, Khan M, Warner JEA, et al. Novel clinical features of glycine receptor antibody syndrome: a series of 17 cases. Neurol Neuroimmunol Neuroinflamm. 2019, 6, 5, e592.

Puledda, F., Schankin, C., Goadsby, P. Visual snow syndrome. A clinical and phenotypical description of 1100 cases. Neurology, 2020, 94, 6, e564-e574.

Santos-Bueso, E., Sastre-Ibanez, M., Saenz-Frances, F., Porta-Etessam, J., Garcia-Sanchez, J. Visual snow. From a symptom to a syndrome? Arch Soc Esp Oftalmol, 2015, 90, 1, 51-52.

Schankin, C., Maniyar, F., Hoffman, J., Chou, D., Goadsby, P. Clinical characterization of “visual snow” (positive persistent visual disturbance). J Headache Pain, 2013, 14, Suppl. 1, 132.

Schankin, C., Maniyar, F., Digre, K., Goadsby, P. ‘Visual snow’ – a disorder distinct from persistent migraine aura. Brain, 2014, 137, 5, 1419-1428.

Schankin, C., Goadsby, P. Visual snow – persistent positive visual phenomenon distinct from migraine aura. Curr Pain Headache Rep, 2015, 19, 23.

Schankin, C, Viana, M., Goadsby, P. Persistent and repetitive visual disturbances in migraine: a review. Headache, 2017, 57, 1, 1-16.

Yildiz, F., Turkyilmaz, U., Unal-Cevik, I. The clinical characteristics and neurophysiological assessments of the occipital cortex in visual snow syndrome with or without migraine. Headache, 2019, 59, 484-494.

Yoo, Y., Yang, H., Choi, J., Kim, J., Hwang, J. Neuro-ophthalmologic findings in visual snow syndrome. J Clin Neurol, 2020, 16, 4, 646-652.