Published: August 21, 2019
Updated: September 23, 2021
Migraine aura without headache, sometimes referred to as “silent migraine,” does not feature any head pain.
By Dr. Jennifer Robblee
Headache can be a common migraine symptom. But not all forms of migraine come with headache. “Migraine aura without headache”—previously known as “acephalgic migraine” and sometimes called “silent migraine”—is when someone has a migraine aura without any head pain.
Despite a lack of head pain, migraine aura without headache is still disabling for those who live with it. It also has its own set of considerations for diagnosis and treatment. The following is a breakdown of the basics of this form of migraine.
To read full article, please click here
Alison M. Harris
Department of Psychological Science, Claremont McKenna College, Claremont, CA, United States
Visual snow syndrome, characterized by persistent flickering dots throughout the visual field, has been hypothesized to arise from abnormal neuronal responsiveness in visual processing regions. Previous research has reported a lack of typical VEP habituation to repeated stimulus presentation in patients with visual snow. Yet these studies generally used pattern-reversal paradigms, which are suboptimal for measuring cortical responses to the onset of foveal stimulation. Instead, these responses are better indexed by the C2, a pattern-onset VEP peaking 100–120 ms after stimulus onset. In this case study, we analyzed the C2 and its adaptation profile in data previously collected from a single patient with visual snow using a “double-pulse” presentation paradigm. In controls, shorter intervals between stimulus pairs were associated with greater attenuation of the C2 VEP, with recovery from adaptation at longer stimulus onset asynchronies (SOAs). However, the visual snow patient showed the opposite pattern, with reduced C2 amplitude at longer SOAs despite distinct C2 peaks at the shortest SOAs. These results stand in contrast not only to the pattern of C2 VEP attenuation in controls, but also to a lack of adaptation previously reported for the pattern-onset P1 VEP in this patient. Exploratory source localization using equivalent current dipole fitting further suggested that P1 and C2 VEPs in the visual snow patient arose from distinct sources in extrastriate visual cortex. While preliminary, these results support differential patterns of VEP attenuation and potentiation within the same individual, potentially pointing toward multiple mechanisms of abnormal neuronal responsiveness in visual snow syndrome.
To read the full article please click here or download PDF below.
My name is Cindy Miller and I have had Visual Snow Syndrome for most of my life. In fact, I can’t seem to remember when it started. I have suspected that I had this syndrome many years ago as I have seen various posts on the symptoms. It seems recently that VSS has come to light and its about time. I have been to so many eye docs and doctors who have tried to treat the symptoms separately. I have not run across any specialist that is aware of VSS or even remotely interested in learning more about VSS.
I wear Irlen filtered glasses ( I am a certified screener) and the lenses have been a big coping mechanism for me to cope with life without chronic headaches. Otherwise the world, spins and swirls and reading is very difficult for me. I was not aware of the other various symptoms of VSS such as tinnitus, lack of night vision and depersonalization. and anxiety. I have always suffered from great anxiety and feel that my brain is on constant overload. Additionally, I am blind in my left eye and the VSS in my right eye makes everything much harder.
My hope is that someday I will be able to receive the right treatment for VSS and maybe encounter the chance to see things clearly. Thank you Eye On Vision for your research and awareness!
Disease & Epidemiology
Palinopsia refers to a pathological group of visual symptoms in which there is an abnormal persistence or recurrence of an image in time. Palinopsia derives its name from the Greek word palin which means "again" and opsia which means "seeing.”
Palinopsia is distinct from a physiological after-image, which is a benign, normal response in which an image briefly persists after a person has stopped looking at the original visual stimulus. Images from palinopsia are longer-lasting and more intense than physiological after-images. Whereas physiological after-images appear immediately after removal of the original visual stimulus, palinopsia after-images may appear immediately or after a time interval. Images from palinopsia are positive images, or the same colors as the original visual stimulus, whereas physiological after-images are negative images, or complementary colors of the original visual stimulus.
Palinopsia can be categorized into two general categories: hallucinatory palinopsia and illusory palinopsia. Individuals with hallucinatory palinopsia see images that are long-lasting, high-resolution, and occur anywhere within the visual field. Individuals with illusory palinopsia see images that are affected by immediate environmental factors, such as light and motion. The images from illusory palinopsia are short-lasting, low-resolution and indistinct.
There is limited data on the epidemiology of palinopsia. Palinopsia may occur in up to 10% of migraineurs and seem to occur more frequently in migraine with aura than without aura. Although migraines occur more frequently in females than males and more frequently in younger to middle aged populations than elderly populations, there have not been significant studies done comparing palinopsia between the categories.
Original article contributed by:
Angela Huang, Aroucha Vickers, DO, Claudia Prospero Ponce, MD
Link to full article click here
The authors write a very comprehensive review of palinopsia, which is the persistence or recurrence of a visual image after the stimulus has been removed. They comment on visual snow, epileptic discharges, release phenomena, medications and illicit drugs, in addition to visual trailing, migraine and light streaking. This is a must-read for anyone interested in palinopsia.
Feb 02, 2015
By Michael Vaphiades, DO
Full article click here
A Study Protocol for an Open-Label Feasibility Treatment Trial of Visual Snow Syndrome With Transcranial Magnetic Stimulation
Marissa Grande, Lucas Lattanzio, Isabelle Buard, Allison M. McKendrick, Yu Man Chan and Victoria S. Pelak
Background: Visual Snow (VS) syndrome is believed to be due to aberrant central visual processing. Positron Emission Tomography (PET) brain imaging and visual evoked potential studies provide evidence for excessive neuronal activity in the medial temporal lobe, specifically the lingual gyrus, and suggest the VS syndrome is a hyperexcitability syndrome. These data provide the basis for consideration of repetitive transcranial magnetic stimulation (rTMS) as a potential treatment for the VS syndrome.
Objective: To publish the study protocol for a pilot study underway at the University of Colorado School of Medicine to investigate the use of rTMS intervention to improve symptoms and visual dysfunction associated with VS. The study aims to determine the adverse events and drop-out rate, evaluate performance of outcome measures, including a novel VS symptom scale, and describe changes in outcomes associated with treatment.
Methods and Design: Up to 10 participants meeting criteria for VS syndrome, age 19–65 years, will undergo an open-label intervention consisting of 10 rTMS sessions, occurring 5 days a week over a 2-week period. Participants will complete pre-treatment and post-treatment assessments that include: the Colorado Visual Snow Scale (CVSS), the National Eye Institute Visual Functional Questionnaire—25 (VFQ-25), the General Anxiety Disorder—7 scale (GAD-7), and three psychophysical visual processing tasks.
Discussion: Knowledge gained from this pilot study will inform future study planning and provide valuable lessons for future investigation of rTMS for the VS syndrome. An overview of study proceedings thus far demonstrates recruitment challenges associated with the COVID-19 pandemic, and additional challenges that are unique to the VS syndrome and to treatment schedules associated with TMS.
Registration: This study has been approved by the Colorado Multiple Institutional Review Board. ClinicalTrials.gov Identifier: NCT04925232.
Full Study Protocol Click Here or click below to download the PDF
My name is Stuart Major, I am a UK citizen living in Cheshire.
I can remember at the age of 23 coming down with some kind of virus that laid me up for about a week. All my senses were affected by this which seemed normal at the time. When I got over this, everything returned to normal apart from my vision which still retained a grainy/static condition to
it. (This also included poor night-time vision).
I went to my GP and tried to explain what I was experiencing, but it was so hard to try and explain. They tried a number of things over a duration of months/years and in the end held their hands up and said “Sorry, we give up, we can’t think of anything else to try and we don’t know what it is you
After a while, I became accustomed to this experience (I couldn’t work as an Illustrator/Artist any
longer) and learned to live life normally with this, sometimes forgetting about it for days, I was
happy-ish again. This stayed constant not getting worse or better.
Many years later at the age of 48, I noticed that the static got worse, along with this I developed
tinnitus, dizziness, floaters, after images, brain fog and a constant pressure in my head. Not thinking
this was related I went to the GP again who intern sent me to an Ophthalmologist/Neurologist who
couldn’t find anything wrong with me after many tests/scans.
By this time I was suffering from depression and was in a dark place as I now had a wife, a teenage
son and a demanding job and was worried that I couldn’t keep on top of things!
Around this time I went for an annual standard eye examination at the optician which was normal.
Then the Optician asked me if there was anything with my vision that I wanted to discuss. I just
thought that I would mention the grainy vision that I had had for many years now. Their reply was
“This sounds a bit like a new condition that the medical field have now acknowledged called Visual
Snow”. I immediately went back to the office and ‘Googled’ this and ‘EUPHORIA’!!
I had finally found out what I was suffering from and that it was a condition with a name and there
were others going through this (which was kind of comforting – not in a horrible way).
I have managed to become a patient of a Neurologist who has written articles on VSS and am
currently being trialled on different treatments.
I am so happy to now see so many organisations out there globally now fighting our coarse and
looking for funds to try and find a treatment/cure for VSS and great progress has been made with
regards to the area of the brain the hyperactivity is coming from and I honestly think that we shall
get there soon!...........So please stay strong and let’s hope for a happy 2022!
VSS PATIENTS NEEDED
Here is a message from Dave Marques
He can be reached via email firstname.lastname@example.org
I'm a master's student at Columbia Journalism School and for my capstone project (our equivalent of a thesis) I'm writing a ~5000 word magazine feature on visual snow. It will largely be a personal narrative, but substantially interspersed with interview and research material. I myself have visual snow syndrome (since June 2019) and would love to speak with others about their experiences with VSS - symptoms, adaptation strategies, etc.
If you feel comfortable sharing your story, I would love to hear from you! There is very little coverage of VSS in the press and I hope to bring the condition to the wider public's attention.
(Two things to note up front: (1) I am planning to pitch the piece to a mainstream media outlet once it's complete; (2) I will need to use your first and last names in the article. I unfortunately cannot use pseudonyms, initials, first name only, or anonymous attribution).
If you're interested, send me a PM and we can set up a time to talk. Zoom is preferable, but a phone call is fine as well. (If you are in New York City, meeting in-person outdoors is also an option but definitely not an expectation!).
Dave Marques can be reached via email email@example.com
Binocular vision dysfunction (BVD) encompasses a group of conditions where the two eyes have difficulty working together as a team, resulting in a vertical or horizontal (or both) misalignment between the line of sight of one eye with the other eye. Subtle vision misalignment can be congenital/spontaneous or precipitated by a brain injury/concussion, and has many non-visual symptoms including dizziness and other vestibular symptoms, headache, neck ache, anxiety, and difficulty reading. There has made little progress in identifying and treating this condition, most likely because the standard vision alignment tests are not sensitive enough to find these subtle misalignments.
To read the full article, please click here to go to VeDA's website or download the PDF below.