This paper sought to demonstrate that diagnosable malingering does occur in Electrical Injury (EI) and examine the relationship of malingering to potential indicators of the presence and severity of neurological injury. Eleven consecutive EI patients seen for neuropsychological evaluation were presented. Over half the patients met the Slick et al. (1999) criteria for at least Probable MND. Most of the MND patients lacked evidence of a biologically meaningful exposure to electrical current. These findings highlight the importance of considering biological markers of neurological injury and of non-neurological factors, including effort/malingering, in the study of the neurocognitive consequences of EI.
Electrical injury (EI) is a potential source of injury and death and most EI (excluding lightning strike) occur in the workplace (Duff & McCaffrey, 2001; Gourbiere, Corbut, & Bazin, 1994; Heilbronner & Pliskin, 1993). A number of studies have demonstrated cognitive performance deficits in EI patients and the observed patterns of cognitive symptoms and neurobehavioral deficits are very similar to those seen in traumatic brain injury (TBI; see Duff & McCaffrey, 2001, for an excellent review). However, in contrast to the recovery pattern in TBI, there has been speculation that EI may result in persistent, progressive, and/or delayed-onset neurocognitive and emotional effects (e.g., Farrell & Starr, 1968; Barrash, Kealey, & Janus, 1996; Pliskin et al., 1994, Pliskin et al., 1998 and Pliskin et al., 1999). Many EI patients reporting neurocognitive impairment have suffered clearly demonstrable neurological injuries that one would expect to produce significant neurocognitive sequelae (e.g., coma, focal neurological signs; Hopewell, 1983). However, the neuropathology in other cases is more ambiguous. Therefore, when attempting to attribute cognitive deficits to the direct neurological effects of an electrical exposure, it would be helpful to have indicators that the body had actually absorbed a sufficient amount of electrical energy to produce injury.
