Interest of Immersive Virtual Reality on Stress During Botulinum Toxin Injections in Spasticity (RVTOX)

Botulinum toxin injections is very frequently used in the treatment of spasticity after central neurological damage (stroke, multiple sclerosis, spinal cord injury, head trauma). The injections may be painful and the tolerance of the injections varies from one patient to another. The pain felt during the injection causes in most patients great stress during the injection.

Virtual reality is a video technique with 360 ° vision simulating the physical presence of the patient in an "existing" environment outside the hospital setting. This technique has been used in painful procedures but only one publication, in pediatrics, has shown a decrease in pain and agitation during botulinum toxin injections.

The hypothesis of this research is that an immersive virtual reality system can, in adults, reduce stress and the painful experience of botulinum toxin injections.

Inclusion criteria

• Adult patient, male or female, suffering from spasticity of neurological origin (multiple sclerosis, stroke, head trauma, etc.) and eligible for treatment by botulinum toxin injection
• Able to give an informed consent to participate in research
• Affiliation to Social Security.

Exclusion criteria

• Contraindication to virtual reality (epilepsy, schizophrenia, strabismus, amblyopia, anisometropia, local contraindication to wearing a helmet (lesion of the face or the skull)
• Major cognitive disorders
• Any medical condition deemed by the investigator to be incompatible with the research.
• Indication of sedation by MEOPA during botulinum toxin injection sessions.
• Patients who have already experienced virtual reality
• Drug treatment or medical condition that may affect heart rate variability
• Pregnant or breastfeeding women
• Patients under safeguard of justice
• Refusal of participation.