Malingering on the VENG/ENG

Timothy C. Hain, MD • Page last modified: March 27, 2021Return to testing index

It is rare to encounter individuals pretending to be dizzy. Usually this effort is motiviated by an attempt to obtain some advantage. For example, there may be litigation going on where compensation depends on demonstration of illness. Sometimes the individual gains by demonstrating that they are disabled, or worthy of special treatment by the government in some way. Sometimes illness is a method to cement dependency relationships.

Malingering, like other forms of deceit, is detected through observation of inconsistency. Inconsistency is most easily detected when there is a combination of subjective and objective measures. In malingering, the modifiable (subjective) tests are poorer than the unmodifiable (objective) tests.

Methods by which individuals can attempt to establish illness where none exists.

The ENG (or VENG if you prefer), is almost entirely modifiable by effort. One can make it meaningless.

Methods of altering the ENG that we have encountered.

  1. Avoid it entirely - - be very difficult, pretend to be deaf, pretend to have no comprehension of English.
  2. Be uncooperative -- do the opposite of instructions. This is usually rather noticable and may result in the person doing the test to note that the client is just uncooperative. This is not very helpful for individuals attempting to be ill. In litigation cases, it may result in the litigation failing.
  3. Close one's eyes -- this results in no data at all.
  4. Cross one's eyes. This can result in a pattern that resembles nystagmus.
  5. Pretend to have a panic attack.

It is worth noting that the VHIT test is much more difficult to "throw". It can be done, but it isn't very easy. The rotatory chair test is similar to the VENG/ENG test in that it requires cooperation.