Visual snow syndrome and its relationship with migraine

O. Barrachina-Esteve , I. Hidalgo-Torrico , C. Acero , S. Aranceta , D. Cánovas-Vergé , G. Ribera
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Abstract

Introduction

Visual snow syndrome (VSS) is a central nervous system disorder that consists of the constant perception of small black and white dots throughout the entire visual field.

Development

VSS can present from infancy to old age, with greater prevalence in the young population, and shows no difference between sexes. The diagnostic criteria include the presence of visual snow and such other visual phenomena as palinopsia, photophobia, nyctalopia, and other persistent visual phenomena. The pathophysiology of VSS is unknown, but hyperexcitability of the visual cortex and a dysfunction in higher-order visual processing are postulated as potential mechanisms. The prevalence of migraine among patients with VSS is high, compared to the general population, and symptoms are more severe in patients presenting both conditions. No effective treatment is available, but the drug with the best results is lamotrigine, which is recommended only in selected cases with severe functional limitation.

Conclusions

VSS is a little-known and underdiagnosed entity, but the increasing number of studies in recent years has made it possible to establish diagnostic criteria and begin studying its pathophysiology. This entity is closely related to migraine, with overlapping symptoms and probably shared pathophysiological mechanisms.

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视觉雪综合征及其与偏头痛的关系
导言视觉雪综合征(VSS)是一种中枢神经系统疾病,包括在整个视野中持续感知小黑点和小白点。视觉雪综合征从婴儿期到老年期均可发病,在年轻人群中发病率较高,且无性别差异。诊断标准包括出现视雪和其他视觉现象,如视苍白、畏光、夜盲症和其他持续性视觉现象。VSS 的病理生理学尚不清楚,但据推测,视觉皮层过度兴奋和高阶视觉处理功能障碍是其潜在机制。与普通人相比,VSS 患者中偏头痛的发病率很高,而且这两种情况的患者症状都更为严重。目前尚无有效的治疗方法,但效果最好的药物是拉莫三嗪,建议仅用于功能严重受限的特定病例。结论VSS 是一种鲜为人知且诊断不足的疾病,但近年来越来越多的研究使我们有可能建立诊断标准并开始研究其病理生理学。这种疾病与偏头痛密切相关,症状重叠,病理生理机制也可能相同。
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