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What Is Palinopsia?

Medically Reviewed by Dan Brennan, MD on June 02, 2021

“Palin” is ancient Greek for “repeat,” and “opsia” is the ancient Greek for “see.” Palinopsia is when you see an image repeatedly even when the image’s stimulus has gone away. Palinopsia is unique to after-images because there is always an interval of time between the original stimulus and the palinopsia. It takes place in the temporal, occipital, and parietal lobes in your brain.

Palinopsia also always has the same exact colors as the original image. Rather than being a condition, palinopsia is a broad term to describe many different conditions.

Causes of Palinopsia

Palinopsia can be organized into two categories: hallucinatory palinopsia and illusory palinopsia. The causes for each type and the causes of palinopsia as a whole are still relatively mysterious. These two categories do offer some information into what may be causing the palinopsia. Although more research is needed, it can be understood generally in these two categories. 

Hallucinatory Palinopsia

Hallucinatory palinopsia is linked to disturbances within the brain’s ability to store visual stimuli. It is often a sign of a condition related more to the brain rather than to outside factors. Things like posterior cortical lesions or seizures can cause these disturbances.

Posterior cortical lesions are most often caused by an underlying cause of Alzheimer’s disease.

However, more specifically, some of the lesions that are associated with hallucinatory palinopsia are:

  • Neoplasms, which are abnormal tissue masses that grow when they shouldn't.
  • Infarctions, when tissue is injured or dies due to lack of blood flow.
  • Hemorrhages, which are strokes that happen when a blood vessel in your brain bursts
  • Arteriovenous malformations, when blood vessels form incorrectly in your body { Johns Hopkins Medicine: "Arteriovenous Malformations."}.
  • Aneurysm, when a blood vessel in your brain bulges or balloons.
  • Abscesses, tender masses usually caused by bacteria or an infection
  • Tuberculomas, a rare but serious form of tuberculosis.

The seizures that cause hallucinatory palinopsia can be caused by various metabolic issues, such as:

Hallucinatory palinopsia creates images that are long-lasting, clear, and that move. They can happen anywhere in your vision field. 

Illusory Palinopsia

While hallucinatory palinopsia is related to image storage within your brain, illusory palinopsia has more to do with outside stimuli like lighting and movement.

While sometimes it is not clear what causes illusory palinopsia, there have been proven links to it through these conditions: 

The medications most commonly linked with causing illusory palinopsia are trazodone, nefazodone, risperidone, and mirtazapine.

The psychedelic drugs most associated with illusory palinopsia are LSD, marijuana, mescaline, and ecstasy. Usually, illusory palinopsia is a one-time event.

Because illusory palinopsia is related to external visual factors, it is characterized by fuzzy, unclear, moving images that are rather quick and short-lasting. 

Palinopsia and Migraines

The link between palinopsia and migraines is speculated to be underdiagnosed. One study found that 10% of people who experience migraines experienced illusory palinopsia. 

Another study linked people who see auras, lights, and shapes that appear across the visual field shortly before a migraine as more likely to have palinopsia.

Diagnosis

Palinopsia is diagnosed by doctors. Regardless of whether it is illusory or hallucinogenic palinopsia, your doctor should do full visual and neurological testing as well as take a look into your medical history. 

The visual field tests are most helpful to detect the causes and conditions for illusory palinopsia. 

Neuroimaging, however, is most often done for people with hallucinatory palinopsia because its effects can indicate more serious neurological diseases. Even if you only experience one bout of hallucinatory palinopsia, you should at least get magnetic resonance imaging (MRI)

Misdiagnosis

Palinopsia can sometimes be mistaken for other conditions, including those that may cause or aggravate it. While some of these misdiagnoses could be related to palinopsia, it is important to understand the difference between a symptom and an underlying condition. This is due to the possible neurological effects of palinopsia.

Some of these conditions or situations that may be related are: 

  • Issues with medications 
  • Bad reactions to drugs
  • Disturbances with your metabolism
  • Mental health disorders like schizophrenia
  • Cerebral (brain) lesions

Treatment

Most often, palinopsia is minor and does not require further treatment. However, it can be a sign of more serious conditions, so it is important that you seek medical attention if you think you have experienced either illusory or hallucinatory palinopsia. 

When palinopsia is caused by seizures, treatment of the seizures helps to take away the palinopsia. This is also true of palinopsia caused by lesions, migraines, or other underlying conditions that cause it. 

Illusory palinopsia is often treated with medication that calms down your neurons. These medications could be something like clonidine, gabapentin, acetazolamide, magnesium, or calcium channel blockers. Doctors often also prescribe sunglasses and tinted lenses to help with your symptoms. 

More research is needed to truly understand palinopsia and its causes, conditions, and symptoms. While it is considered rare, it may be more common than we think due to being underdiagnosed. 

Show Sources

SOURCES: 

American Academy of Ophthalmology: “Palinopsia.”

BMJ Case Reports: "Palinopsia from a posteriorly placed glioma – an insight into its possible causes."

Johns Hopkins Medicine: "Arteriovenous Malformations."

Mayo Clinic: "Brain aneurysm," “Migraine aura."

Merriam-Webster: "infarction."

National Cancer Institute: "neoplasm."

Respiratory Medicine Case Reports: "Cerebral tuberculomas – A clinical challenge."

UCSF Weill Institute for Neurosciences: “Posterior Cortical Atrophy.”

University of Utah Library: “Palinopsia.”

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