How Common Is Migraine in Visual Snow with Versus Without Hallucinogen Persisting Perception Disorder?

A study evaluated the frequency of migraine among people with Hallucinogen Persisting Perception Disorder (HPPD) presenting as visual snow syndrome (VSS).

A Dutch consulting clinic for recreational drug use was used to recruit 24 people with persistent visual snow following illicit drug use. Participants took part in structured interviews regarding perceptual symptomatology, details of drug use, and medical and headache history. Thirty-seven people with visual snow without a history of HPPD were also interviewed for comparison.

There were no cases of migraine among the people with HPPD, but more than half of controls had migraine (54.1%; P<0.001). Both groups had a median Visual Snow Handicap Inventory score of 38 out of 100. Most cases of visual snow in HPPD cases started after taking ecstasy (70.9%). Additional drugs used included cannabis, psilocybin mushrooms, amphetamine, 4‐FMP, 3‐MMC, 2C‐B, and nitrous oxide.

The study was published in the European Journal of Neurology.

“While none of the HPPD participants had migraine, over half of the visual snow controls without prior use of illicit drugs had migraine. This suggests that at least partly different pathophysiological factors play a role in both disorders,” the researchers wrote in their conclusion. “Further studies are needed to enhance understanding of the underlying neurobiology of HPPD and VSS to come to better management of these conditions.”