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    Research Letter
    November 25, 2019

    Episodic Visual Snow Associated With Migraine Attacks

    Author Affiliations
    • 1Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
    JAMA Neurol. 2020;77(3):392-393. doi:10.1001/jamaneurol.2019.4050

    Visual snow syndrome (VSS) is a debilitating disorder characterized by continuous visual snow (VS), ie, tiny flickering dots in the entire visual field resembling the view of a badly tuned analog television (Figure), plus additional visual symptoms, such as photophobia and palinopsia. There is a high comorbidity with migraine and migraine aura.1 To our knowledge, this is the first report of patients with an episodic form of VS (eVS), strictly co-occurring with migraine attacks.

    Between January 2016 and December 2017, we saw 3 patients with eVS and 1934 patients with migraine at our tertiary outpatient headache center. Diagnoses were made according to the International Headache Society International Classification of Headache Disorders-32 and our previous work,1 except for the requirement of permanence for VS. The case series was approved by the Cantonal Ethics Committee Bern (Req-2017-00698) with waiver of written informed consent based on general consent given by all patients.