vasy

I had 1g of methylprednisolone together with a potent immune-depleting drug for 5 days for the autoimmune disease of the CNS. It certainly did nothing to my visuals may be they got even worse temporarily because this treatment made me very-very sick in general for a couple of weeks or so. When I was diagnosed with this autoimmune condition I thought that visual snow and trails are related to it and my neuro told that he thinks the same. But after reading the literature (which is to say scarce on the subject) I don't think so anymore. Also my immune system is nearly completely destroyed after the treatment I got, and all other neurological symptoms I got prior to it pretty much improved. But not visual distortions.

There are few case reports in which Lamictal made visual snow and trails worse or induced it in patients with migraine who had mild or none at all prior to treatment. But also there are contradicting reports in which lamotrigine alleviated visual symptoms in PHHD and other patients with migraine. So the evidence is small and contradicting, maybe Keppra considered better because of this contradiction in evidence. (but on Keppra I personally found nothing at all).

Hi xspeciem There are few case reports available via pubmed/epub in which Lamotrigine itself induced persistent visual snow and palinopsia/trails in patients with migraine, who got no such symptoms before. But also there are few reports on patients with PHHD and migraine who had their visual perception improved on Lamotrigine, so possibly it is not solution for everyone and potentially can make PHHD worse. I found no data on this. The mainstream hypothesis now is that aeropsias/palinopsia/etc are generally related to a hyperactive visual cortex, which is possibly determined by the genetics and/or early stages of development. If this hypothesis is correct, then PHHD (and permanent aura in migraine and epilepsy) are possibly pre-existing conditions, you only notice them when cortical self-inhibitory mechanisms become downregulated or somehow insufficient to inhibit excessive activity in visual analyser which allows it to generate all that weird stuff out from nowhere. So possible time from onset should not matter at all, this thing is there much longer then you notice it. Although there are some personal opinions that PHHD related symptoms tend to improve over time span of years-decade on it's own.