Palinopsia

Palinopsia can feel unsettling because it makes visual images linger or reappear after the original object is gone. This is not the same as a normal afterimage. Changes in the brain or eyes that disrupt how visual information is processed often cause palinopsia.

Several conditions can trigger this symptom. Neurological issues such as seizures, migraines, or strokes commonly cause it. Eye problems, head injuries, and certain medications can also play a role. Sometimes, palinopsia appears without a clear medical condition, which makes it harder to trace.

Definition of Symptom

Palinopsia is a visual disturbance where a person continues to see an image even after the original object is no longer present. This makes it different from normal afterimages, which are usually brief and fade quickly.

This symptom belongs to a group of visual phenomena linked to how the brain processes visual information. Instead of clearing the image once the eyes shift, the brain repeats or holds on to it. People may describe palinopsia as:

• Lingering images that stay in view after looking away.
• Trailing effects occur when moving objects create streaks or duplicate patterns in their wake.
• Reappearing visuals that show up again without the object being present.

These visual symptoms can feel disruptive because they interfere with normal sight. For some, the images appear faint or transparent, while for others they may look more solid and distracting. Palinopsia can occur in short episodes or persist for longer periods. The variation often depends on the underlying cause, which may involve the eye, brain, or both.

In simple terms, palinopsia means seeing an image after the object is gone. This is different from other common visual disturbances such as glare, flashes, or floaters. The symptom is not a disease itself but a sign that something is affecting the visual system. Because it can appear with neurological or eye-related conditions, it is important to describe clearly and recognize early.

Possible Causes/Diseases Condition

Many different medical conditions that affect the brain or visual system can cause palinopsia. It often relates to how the brain processes visual information rather than a problem with the eyes themselves. Common causes include:

• Migraines, especially those with visual auras
• Seizures and epilepsy
• Head trauma or injury
• Structural brain lesions such as tumors or infarctions

Some metabolic and rare disorders may also play a role. For example, carnitine deficiency can disrupt brain function and trigger visual disturbances. Neurodegenerative diseases like Creutzfeldt-Jakob disease can also cause persistent visual symptoms, including palinopsia.

Vascular conditions sometimes contribute. An aneurysm, arteriovenous malformation, or stroke-related infarction can disrupt areas of the brain where vision is processed. Other reported associations include:

• Neoplasms (brain tumors).
• Tuberculomas (inflammatory brain lesions).
• Ion channel disturbances that affect nerve signaling.

Psychiatric and drug-related conditions may also be involved. Hallucinogen persisting perception disorder (HPPD) can cause recurring visual afterimages long after drug use. Schizophrenia has occasionally been linked to similar visual distortions, though less commonly.

Cause Type	Examples
Neurological	Migraines, seizures, epilepsy
Structural brain lesions	Tumors, infarctions, tuberculomas
Vascular	Aneurysm, arteriovenous malformation
Metabolic/rare	Carnitine deficiency, CJD
Psychiatric/drug-related	HPPD, schizophrenia

Each of these conditions can affect the visual pathways, leading to the recurring or persistent images seen in palinopsia.

Other Non-Disease Causes

Not all cases of palinopsia come from disease. Some are linked to normal vision responses or outside factors that affect the brain and eyes. A physiological afterimage is one example.

This harmless effect happens when the eyes continue to see an image for a short time after looking away. Unlike pathological palinopsia, this fades quickly and does not signal a health problem. Certain medications can cause palinopsia-like symptoms. Examples include:

• Selective estrogen receptor modulator (SERM)
• Tetracyclic antidepressant
• Serotonin antagonist and reuptake inhibitor (SARI)
• Atypical antipsychotic
• Anticonvulsant
• Carbonic anhydrase inhibitor
• Alpha-2 adrenergic agonist
• Anticonvulsant and neuropathic pain agent

These drugs may change how the brain handles visual signals, leading to lingering or repeated images. Stress and anxiety can also play a role. High stress levels may make the brain more sensitive to visual disturbances, which can increase the chance of experiencing palinopsia.

Factor	Example/Notes
Normal visual effect	Physiological afterimage
Medication side effect	Selective estrogen receptor modulator (SERM), tetracyclic antidepressant, serotonin antagonist and reuptake inhibitor (SARI)
Psychological factors	Stress, anxiety
Visual aids	Tinted lenses, sunglasses

How It Causes the Symptom

Abnormal processing of visual information in the brain causes palinopsia. Instead of clearing an image once the eyes move away, the brain continues to replay or distort it. This leads to afterimages or repeated visual impressions that linger longer than they should. There are two main types:

• Hallucinatory Palinopsia: Detailed, long-lasting images that may resemble visual hallucinations.
• Illusory Palinopsia: Less distinct, often linked to environmental factors like light and motion, such as visual trailing or light streaking.

In hallucinatory palinopsia, certain brain areas that store or recall visual memory may misfire. This can cause persistent palinopsia, where objects remain visible even after the original stimulus is gone. Illusory palinopsia often relates to how the eyes and brain adapt to brightness or movement.

For example, a person may see streaks of light following moving objects or faint trails that resemble extended afterimages. Doctors may use scans or simple vision tests to check for underlying causes and see how the eyes and brain interact during these episodes. These symptoms can appear alone or with other conditions.

Possible Complications

Palinopsia can affect daily activities such as reading, driving, or working on digital screens. Persistent afterimages may distract attention and make it harder to process new visual information. Some people experience increased anxiety or stress when they cannot trust what they see. This can lead to avoidance of social situations or reduced confidence in normal tasks.

In certain cases, palinopsia may signal an underlying neurological disorder. Conditions such as seizures, migraines, or brain lesions can carry their own risks if not addressed. Common complications may include:

• Difficulty with concentration.
• Visual confusion in busy environments.
• Sleep disruption from lingering images.
• Emotional strain due to uncertainty about symptoms.

When to Seek Medical Attention

Do not ignore sudden or worsening symptoms of palinopsia. While some cases are mild, others can point to underlying neurological issues that need quick evaluation. Seek medical care right away if palinopsia appears suddenly, especially when paired with:

• Severe headaches
• Weakness or numbness
• Speech problems
• Noticeable vision loss

These signs may suggest more than a simple visual disturbance. A healthcare provider can check for conditions such as seizures, migraines, or changes in the brain. In many cases, a neuro-ophthalmologist can help with diagnosis and treatment planning. If symptoms interfere with daily activities, seek help. Even minor symptoms may need evaluation to make sure nothing serious is going on.

Situation	Action
Sudden onset of palinopsia.	Seek immediate medical attention.
Symptoms with neurological changes.	Get emergency evaluation.
Persistent or worsening symptoms.	Schedule an eye or neurology exam.
Unclear cause of visual changes.	Ask for referral to a neuro-ophthalmologist.

Regular follow-up with a trusted healthcare provider can support ongoing care and provide guidance on managing palinopsia safely.