Do virtual reality interventions cause seizures in the critically ill? A rapid review

Area of Science:

• Intensive care medicine
• Neurology
• Medical technology

Background:

• Virtual reality (VR) offers benefits for pain and anxiety in intensive care.
• Concerns exist regarding potential seizure induction by VR, leading to historical exclusion of patients with epilepsy.
• This review addresses the safety of VR in intensive care settings.

Purpose of the Study:

• To systematically review the literature on virtual reality use in intensive care.
• To determine if virtual reality interventions have been associated with seizures in intensive care patients.
• To assess the risk of seizures in patients with a history of epilepsy or photosensitivity undergoing VR.

Main Methods:

• A rapid systematic review and synthesis of qualitative and quantitative data.
• Searched five databases (PubMed, Scopus, EMBASE, PsycInfo, CINAHL) and gray literature from January 2014 onwards.
• Conducted subgroup analyses for adult/pediatric populations and patients with epilepsy history; performed risk-of-bias assessment.

Main Results:

• 27 articles involving 886 patients and 1843 VR sessions (over 614 hours) met inclusion criteria.
• No seizures were reported in intensive care patients undergoing virtual reality interventions.
• The risk of VR-induced seizures appears minimal in this population.

Conclusions:

• Virtual reality is a low-risk intervention in intensive care when used appropriately.
• A history of epilepsy or photosensitivity should not be an absolute contraindication for VR use.
• Clinicians should exercise clinical judgment and select non-strobe visual experiences to mitigate risks.