Onset of visual snow syndrome after first migraine episode in a pediatric patient

Meagan Guay MD and Ana Marissa Lagman-Bartolome MD.  Onset of Visual Snow Syndrome After First Migraine Episode in a Pediatric Patient: A Case Report and Review of Literature. Pediatric Neurology, in press.

ABSTRACT:

Introduction

Visual Snow Syndrome (VSS) is a neurological disorder characterized by persistent positive visual disturbances. VSS is known to be a rare condition, however it is becoming increasingly recognized by neurologists and neuroophthalmologists. Despite this, it is not commonly described in pediatric patients. 

Methods

We describe the case of a pediatric patient with onset of persistent visual phenomena at the age of 13-years, which she described as “TV static,” with associated afterimages, photopsia, nyctalopia, and photophobia. These visual disturbances have persisted for two years. 

Results

The patient’s MRI revealed approximately 15 T2/FLAIR hyperintensities in keeping with changes secondary to migraine. The ophthalmologic examination did not reveal an underlying cause. The patient’s visual symptoms have been resistant to medications. 

Conclusion

VSS is a recently described syndrome that is debilitating to patients. Further case descriptions, characterization of presentation, and management of patients with VSS, specifically in pediatric cases, is required.

From the manuscript

We describe the case of a pediatric patient with visual snow syndrome (VSS) with onset of persistent visual phenomena at the age of 13 years, which she described as “TV static,” with associated afterimages, persistent floaters photopsia, nyctalopia, and photophobia. These visual disturbances started in the days following the patient’s first migraine with visual aura and have persisted for two years. The patient’s MRI revealed approximately 15 T2/FLAIR hyperintensities in keeping with changes secondary to migraine. Ophthalmologic examination did not reveal an underlying cause. The patient’s visual symptoms remained refractory to medications. VSS is a recently described syndrome that is debilitating to patients. It is known to be a rare condition; however, it is becoming increasingly recognized by neurologists and neuro-ophthalmologists. Despite this, it is not commonly described in pediatric patients.

See:  https://childnervoussystem.blogspot.com/2020/02/visual-snow-revisited.html
https://childnervoussystem.blogspot.com/2016/08/visual-snow.html