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Visual Snow: Updates and Narrative Review

  • Uncommon and/or Unusual Headaches and Syndromes (F Cohen, Section Editor)
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Abstract

Purpose of Review

Visual snow (VS) involves visualization of innumerable dots throughout the visual field, sometimes resembling “TV static.” Patients who experience this symptom may also have additional visual symptoms (e.g., photophobia, palinopsia, floaters, and nyctalopia) with a pattern now defined as visual snow syndrome (VSS). This manuscript describes both VS and VSS in detail and provides an updated review on the clinical features, pathophysiology, and optimal management strategies for these symptoms.

Recent Findings

VS/VSS may be primary or secondary to a variety of etiologies, including ophthalmologic or brain disorders, systemic disease, and medication/hallucinogen exposure. Evaluation involves ruling out secondary causes and mimics of VS. Increasing evidence suggests that VSS is a widespread process extending beyond the visual system. Pathophysiology may involve cortical hyperexcitability or dysfunctional connectivity of thalamocortical or attention/salience networks.

Summary

VSS is typically a benign, non-progressive syndrome and can be managed with non-medicine strategies. Though no medication provides complete relief, some may provide partial improvement in severity of VS.

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Authors and Affiliations

  1. Neurology Department, Mayo Clinic College of Medicine and Science, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA

    Jennifer I. Stern & Carrie E. Robertson

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Both authors prepared the main manuscript text and the table. Both authors made substantial contributions to the manuscript and revised it for intellectual content. Both authors approve the current submitted version.

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Correspondence to Carrie E. Robertson.

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Jennifer I. Stern, MD, is a shareholder in Emmyon, a biotechnology company that has no relevance to any topic in this manuscript. Carrie E. Robertson, MD, has previously served on advisory boards for Lundbeck, Biohaven, Impel, Linpharma, and Satsuma. She has received research support from Teva, Pfizer, and Lundbeck, with funds paid to her institution. She also receives royalties as author and section editor for UpToDate.

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Stern, J.I., Robertson, C.E. Visual Snow: Updates and Narrative Review. Curr Pain Headache Rep 28, 55–63 (2024). https://doi.org/10.1007/s11916-023-01186-3

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