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Keywords = visual snow syndrome

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11 pages, 1010 KB  
Review
Visual Snow Syndrome: Therapeutic Implications
by Kenneth J. Ciuffreda and Daniella Rutner
J. Clin. Med. 2025, 14(17), 6070; https://doi.org/10.3390/jcm14176070 - 27 Aug 2025
Cited by 1 | Viewed by 7117
Abstract
Visual snow and its syndrome represent a relatively new and enigmatic neurological condition affecting the human sensory, motor, and perceptual systems. In this narrative review, first an overview of the condition and its basic characteristics and demographics are presented. Then, the six therapeutic [...] Read more.
Visual snow and its syndrome represent a relatively new and enigmatic neurological condition affecting the human sensory, motor, and perceptual systems. In this narrative review, first an overview of the condition and its basic characteristics and demographics are presented. Then, the six therapeutic approaches that have been attempted over the past decade are detailed by a simple discussion of the problem with the patient, medications, special chromatic tints, oculomotor training, visual noise adaptation, and environmental changes, which have met with varying degrees of success. Thus far, chromatic tints and oculomotor training appear to be the most successful. Full article
(This article belongs to the Section Ophthalmology)
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7 pages, 613 KB  
Perspective
Perceptual Uncertainty and Its Monitoring in Visual Snow Syndrome: A Multimodal Framework
by Sophie De Beukelaer, Antonia Klein and Christoph J. Schankin
Clin. Transl. Neurosci. 2025, 9(1), 13; https://doi.org/10.3390/ctn9010013 - 1 Mar 2025
Cited by 1 | Viewed by 3481
Abstract
Neurobehavioral signatures, such as cortical hyperexcitability, thalamo-cortical dysrhythmia, and pulvinar dysfunction, appear to drive the persistent visual misperceptions in Visual Snow Syndrome (VSS). We propose that heightened perceptual uncertainty and impaired metacognitive monitoring perpetuate these disturbances and formalize these processes within different frameworks [...] Read more.
Neurobehavioral signatures, such as cortical hyperexcitability, thalamo-cortical dysrhythmia, and pulvinar dysfunction, appear to drive the persistent visual misperceptions in Visual Snow Syndrome (VSS). We propose that heightened perceptual uncertainty and impaired metacognitive monitoring perpetuate these disturbances and formalize these processes within different frameworks (predictive coding, signal detection theory, and attentional control). By clarifying these mechanisms, we aim to inform targeted interventions that could address this currently untreatable condition. Full article
(This article belongs to the Section Headache)
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10 pages, 246 KB  
Review
Visual Snow Syndrome in Patient with Migraine: Case Report and Literature Review
by Justyna Chojdak-Łukasiewicz and Edyta Dziadkowiak
J. Clin. Med. 2024, 13(5), 1373; https://doi.org/10.3390/jcm13051373 - 28 Feb 2024
Cited by 5 | Viewed by 11565
Abstract
Visual snow syndrome (VSS) is a rarely diagnosed neurological phenomenon. It is a visual disorder characterised by the presence of numerous white, black, or translucent dots in the visual field, resembling the ‘snow’ of an analogue TV set experiencing reception interference. According to [...] Read more.
Visual snow syndrome (VSS) is a rarely diagnosed neurological phenomenon. It is a visual disorder characterised by the presence of numerous white, black, or translucent dots in the visual field, resembling the ‘snow’ of an analogue TV set experiencing reception interference. According to The International Classification of Headache Disorders, 3rd edition, visual snow is defined as a pattern of continuous small dots across the visual field lasting >3 months and accompanied by at least two of the following four additional symptoms: palinopsia, increased entoptic phenomena, photophobia, and nyctalopia. These complaints are not consistent with a typical migraine with visual aura and cannot be better explained by another disorder. The authors present the case of a 39-year-old woman who was diagnosed with VSS. The symptoms appeared after a migraine attack and had not alleviated. The patient reported a sensation of constant ‘TV screen snow’. A neurological examination found no signs of focal damage to the nervous system. The results of the ophthalmological examination, MRI of the brain with contrast, MRI of the eye sockets, and EEG were normal. VSS is a phenomenon that is still not fully understood, different from migraine aura and associated with a number of additional symptoms. VSS is very difficult to treat. In this case, a lot of drugs were used without improvement. Further research must be conducted to determine the best treatment options for these patients. Full article
(This article belongs to the Section Clinical Neurology)
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12 pages, 249 KB  
Review
Visual Snow: A Review on Pathophysiology and Treatment
by Przemysław Rusztyn, Wiktoria Stańska, Anna Torbus and Piotr Maciejewicz
J. Clin. Med. 2023, 12(12), 3868; https://doi.org/10.3390/jcm12123868 - 6 Jun 2023
Cited by 8 | Viewed by 11219
Abstract
Objective: Visual snow (VS) is a rare clinical entity in neuro-ophthalmology. It is described as the presence of flickering dots affecting the whole visual field, often compared by patients to snow or pixelated television static. Importantly, it can be an alarming symptom for [...] Read more.
Objective: Visual snow (VS) is a rare clinical entity in neuro-ophthalmology. It is described as the presence of flickering dots affecting the whole visual field, often compared by patients to snow or pixelated television static. Importantly, it can be an alarming symptom for many patients, lowering their quality of life. Our purpose is to increase awareness of this disease, because many healthcare professionals have difficulty identifying symptoms as the nature of the condition is subjective. In this review, we aimed to describe the updates in the etiology and treatment of visual snow. We searched for articles in English, presenting original data and published after December 2019. Different studies show inconsistent data. Neuroimaging studies found, among other things, hypermetabolism of the lingual gyrus, increased gray matter in different brain areas, and altered connectivity in visual pathways. However, these findings were not present in all patients. According to the literature, among the most effective drugs is lamotrigine. Unfortunately, it also carries a risk of worsening the symptoms. It is crucial to remember that VS can be worsened or induced by alcohol, recreational drugs, and certain medication. In terms of treatment, nonpharmacological approaches such as color filters and repetitive Transcranial Magnetic Stimulation were also used. Interpretation: Further studies are needed to understand the nature of VS fully. Even though the pathophysiology and effective treatment of the condition remains unknown, expanding the knowledge about visual snow can impact the comfort of patients. Full article
(This article belongs to the Section Ophthalmology)
11 pages, 328 KB  
Review
Visual Disturbances Spectrum in Pediatric Migraine
by Ilaria Frattale, Laura Papetti, Fabiana Ursitti, Giorgia Sforza, Gabriele Monte, Alessandra Voci, Martina Proietti Checchi, Luigi Mazzone and Massimiliano Valeriani
J. Clin. Med. 2023, 12(8), 2780; https://doi.org/10.3390/jcm12082780 - 8 Apr 2023
Cited by 4 | Viewed by 6180
Abstract
Migraine is a complex neurological disorder with partially unknown pathophysiological mechanisms. The prevalence in childhood ranges from 7.7% to 17.8%, thus representing the most frequent primary headache. In half of the cases, migraine is accompanied or preceded by various neurological disturbances, among which [...] Read more.
Migraine is a complex neurological disorder with partially unknown pathophysiological mechanisms. The prevalence in childhood ranges from 7.7% to 17.8%, thus representing the most frequent primary headache. In half of the cases, migraine is accompanied or preceded by various neurological disturbances, among which the visual aura is the best known. In literature, other conditions, such as Alice in Wonderland Syndrome and Visual Snow syndrome, are characterized by visual manifestations and are often associated with migraine. The aim of this narrative review is to describe the spectrum of visual disturbances in pediatric migraine and their pathophysiological mechanisms. Full article
(This article belongs to the Special Issue Pediatric Migraine: Clinical Advances in Diagnosis and Treatment)
14 pages, 11304 KB  
Review
Differential Diagnosis of Visual Phenomena Associated with Migraine: Spotlight on Aura and Visual Snow Syndrome
by Eliseo Barral, Elisa Martins Silva, David García-Azorín, Michele Viana and Francesca Puledda
Diagnostics 2023, 13(2), 252; https://doi.org/10.3390/diagnostics13020252 - 9 Jan 2023
Cited by 18 | Viewed by 23764
Abstract
Migraine is a severe and common primary headache disorder, characterized by pain as well as a plethora of non-painful symptoms. Among these, visual phenomena have long been known to be associated with migraine, to the point where they can constitute a hallmark of [...] Read more.
Migraine is a severe and common primary headache disorder, characterized by pain as well as a plethora of non-painful symptoms. Among these, visual phenomena have long been known to be associated with migraine, to the point where they can constitute a hallmark of the disease itself. In this review we focus on two key visual disorders that are directly or indirectly connected to migraine: visual aura and visual snow syndrome (VSS). Visual aura is characterized by the transient presence of positive and negative visual symptoms, before, during or outside of a migraine attack. VSS is a novel stand-alone phenomenon which has been shown to be comorbid with migraine. We discuss key clinical features of the two disorders, including pathophysiological mechanisms, their differential diagnoses and best treatment practices. Our aim is to provide an aid for clinicians and researchers in recognizing these common visual phenomena, which can even appear simultaneously in patients with an underlying migraine biology. Full article
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5 pages, 138 KB  
Article
Mirtazapine for Treatment of Visual Snow Syndrome: A Case Series with Insights into Pathophysiology and Therapy
by Ozan Eren and Christoph J Schankin
Clin. Transl. Neurosci. 2020, 4(1), 9; https://doi.org/10.1177/2514183x20925695 - 20 May 2020
Cited by 5 | Viewed by 1793
Abstract
Background: Patients with visual snow syndrome (VSS) describe tiny flickering dots in the entire visual field resembling the noise of a poorly adjusted channel of analogue television with additional symptoms. Little is known about the pathophysiology and therapeutic options for this debilitating condition. [...] Read more.
Background: Patients with visual snow syndrome (VSS) describe tiny flickering dots in the entire visual field resembling the noise of a poorly adjusted channel of analogue television with additional symptoms. Little is known about the pathophysiology and therapeutic options for this debilitating condition. Objectives: We present a case series of three patients with VSS taking mirtazapine, one of the most often prescribed antidepressants, and discuss the utility of antidepressants by reviewing our current understanding of pathophysiology and therapy. Results: Mirtazapine has no effect on VSS, neither positive nor negative. This is in line with the reports from the literature suggested only some beneficial effects from lamotrigine. Conclusions: Since the pathophysiology of VSS is not fully understood, we still rely on the reports of individual cases or patient series. This includes not only the positive, but also the negative results to avoid unnecessary treatment trials. Looking into the literature, antidepressants do not seem to be a solution for the visual symptoms. So far, best data exists for the anticonvulsant lamotrigine. Full article
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