Purpose

Used to distinguish between sensory and cerebellar ataxia

Examination

The patient is asked to stand with both feet together, raise the arms, and close the eyes.

Interpretation

• Positive Romberg
  • The patient’s coordination is impaired when the eyes are closed and the patient starts swaying or swaying increases
  • Indicates sensory ataxia
    • To remain standing, patients require two of the following: proprioception, vision, and vestibular function.
    • A patient with absent proprioception (dorsal column damage) will lose balance upon closing their eyes because they are left with only vestibular function.
  • An increased tendency to fall sideways after closing the eyes can also indicate a vestibular disorder. In the case of a unilateral vestibular disorder, the patient usually falls towards the side of the lesion.
• Negative Romberg
  • Closing the eyes does not affect the patient’s balance (i.e., swaying does not increase).
  • Uncontrollable swaying, even with the eyes open, is indicative of cerebellar ataxia.