Probable Methylphenidate-Related Reversible “Visual Snow” in a Child With ADHD

Naguy, Ahmed; Naguy, Camellia; Singh, Anubhuti

doi:10.1097/wnf.0000000000000512

Cited by 4 publications

(2 citation statements)

References 8 publications

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“…Medications that should be used cautiously because of the high risk of worsening are atypical antidepressants and ADHD drugs. One work describes full recovery from VSS by the shift from Methylphenidate to Atomoxetine in ADHD treatment [ 35 ]. It is essential to highlight that not all patients are willing to try pharmacological treatment for VSS, possibly due to the fear of side effects, mainly worsening visual symptoms.…”

Section: Discussionmentioning

confidence: 99%

Visual Snow: A Review on Pathophysiology and Treatment

Rusztyn,

Stańska,

Torbus

et al. 2023

JCM

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Objective: Visual snow (VS) is a rare clinical entity in neuro-ophthalmology. It is described as the presence of flickering dots affecting the whole visual field, often compared by patients to snow or pixelated television static. Importantly, it can be an alarming symptom for many patients, lowering their quality of life. Our purpose is to increase awareness of this disease, because many healthcare professionals have difficulty identifying symptoms as the nature of the condition is subjective. In this review, we aimed to describe the updates in the etiology and treatment of visual snow. We searched for articles in English, presenting original data and published after December 2019. Different studies show inconsistent data. Neuroimaging studies found, among other things, hypermetabolism of the lingual gyrus, increased gray matter in different brain areas, and altered connectivity in visual pathways. However, these findings were not present in all patients. According to the literature, among the most effective drugs is lamotrigine. Unfortunately, it also carries a risk of worsening the symptoms. It is crucial to remember that VS can be worsened or induced by alcohol, recreational drugs, and certain medication. In terms of treatment, nonpharmacological approaches such as color filters and repetitive Transcranial Magnetic Stimulation were also used. Interpretation: Further studies are needed to understand the nature of VS fully. Even though the pathophysiology and effective treatment of the condition remains unknown, expanding the knowledge about visual snow can impact the comfort of patients.

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Section: Discussionmentioning

confidence: 99%

Visual Snow: A Review on Pathophysiology and Treatment

Rusztyn,

Stańska,

Torbus

et al. 2023

JCM

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“…The study highlights the need for healthcare professionals to be aware of these potential side effects. Interestingly, Naguy et al [ 28 ] described a case of a child with ADHD who developed visual snow phenomenon, photopsia, and tinnitus under treatment with methylphenidate, a noradrenaline and dopamine reuptake inhibitor. The symptoms were reversible during tapering and appeared to correlate with the dosage [ 28 ].…”

Section: Neuroscientific Research Techniquesmentioning

confidence: 99%

Visual snow syndrome: recent advances in understanding the pathophysiology and potential treatment approaches

Aeschlimann,

Klein,

Schankin

2024

Current Opinion in Neurology

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Purpose of review Visual snow syndrome (VSS) is a disorder characterized by persistent visual disturbances, including the visual snow phenomenon, palinopsia, heightened perception of entoptic phenomena, impaired night vision, and photophobia. The purpose of this review is to provide an update on recent findings over the past 18 months in VSS research and to summarize the current state of treatment approaches. Recent findings Electrophysiological studies have revealed cortical hyperresponsivity in visual brain areas, imaging studies demonstrated microstructural and functional connectivity alterations in multiple cortical and thalamic regions and investigated glutamatergic and serotoninergic neurotransmission. These findings suggest that VSS might be a network disorder. Only few treatment studies are currently available demonstrating limited response to medication and even worsening or triggering of visual symptoms by certain antidepressants. Promising nonpharmacological treatments include mindfulness-based cognitive therapy, the use of chromatic filters, and research on visual noise adaption and neuro-optometric visual rehabilitation therapy (NORT). However, the level of evidence is still low and further research is needed including larger trials and involving objective m easures of individual dysfunction. Summary Although there has been recent progress, we still have not fully understood the nature of VSS. Further research is needed on a clinical and pathophysiological level to successfully treat the condition.

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