Natural course of visual snow syndrome: a long-term follow-up study

Michael Graber, Adrian Scutelnic, Antonia Klein, Francesca Puledda, Peter J Goadsby, Christoph J Schankin

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9 Citations (Scopus)


Visual snow syndrome is characterized by a continuous visual disturbance resembling a badly tuned analogue television and additional visual and non-visual symptoms causing significant disability. The natural course of visual snow syndrome has not hitherto been studied. In this prospective longitudinal study, 78 patients with the diagnosis of visual snow syndrome made in 2011 were re-contacted in 2019 to assess symptom evolution using a semi-structured questionnaire. Forty patients (51% of 78) were interviewed after 84 ± 5 months (mean ± SD). In all patients, symptoms had persisted. Visual snow itself was less frequently rated as the most disturbing symptom (72 versus 42%, P = 0.007), whereas a higher proportion of patients suffered primarily from entopic phenomena (2 versus 17%, P = 0.024). New treatment was commenced in 14 (35%) patients, of whom in seven, visual snow syndrome was ameliorated somewhat. Three (7%) experienced new visual migraine aura without headache, and one (2%) had new migraine headache. There were no differences in the levels of anxiety and depression measured by the Patient Health Questionnaire 8 and the Generalized Anxiety Disorder Scale 7. Thirty-eight patients (49%) were lost to follow-up. In visual snow syndrome, symptoms can persist over 8 years without spontaneous resolution, although visual snow itself might become less bothersome. [Abstract copyright: © The Author(s) 2022. Published by Oxford University Press on behalf of the Guarantors of Brain.]
Original languageEnglish
Pages (from-to)fcac230
JournalBrain Communications
Issue number5
Early online date9 Sept 2022
Publication statusE-pub ahead of print - 9 Sept 2022


  • visual snow
  • follow-up
  • migraine
  • aura
  • natural course


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