Romberg test

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The Romberg test (Romberg test) is a test used to detect proprioceptive disorders. It is based on the appreciation of the ability to maintain balance in the absence of visual stimuli. The Romberg test is frequently used to assess the nature of gait disorders (ataxia), ataxia associated with the positive Romberg test will be due to profound sensitivity disorders while ataxia in the presence of a negative Romberg test will be evidence of the cerebellar nature of ataxia.

Procedure

Maintaining the orthostatic position is possible only with the participation of at least two of the following elements: superficial sensitivity, deep sensitivity or proprioception and visual stimuli.

To perform the Romberg test, the patient is asked to stand upright with his hands along his body and his toes and heels glued together. Next, the test follows two stages:

  • The patient sits upright with his eyes open. If the balance is maintained in this position, move to the second stage.
  • The patient is asked to close his eyes, so that maintaining the orthostation further will require the integrity of both superficial and deep sensitivity.

If after closing the eyes the patient deviates from the orthostatic position, the Romberg test is considered to be positive, which indicates an impairment of the pathways of deep sensitivity. It is recommended that during the test the examiner stay close to the patient to prevent his fall.

Romberg test positive

The Romberg test is positive in pathologies that cause damage to the pathways of deep sensitivity.

  • Diseases that affect the dorsal spinal horns in which the Gol and Burdach bundle are located, such as dorsal tabes (neurosyphilis), a disease in which the Romberg sign was first described.
  • Diseases affecting the sensory nerves such as chronic inflammatory demyelinating polyradiculoneuropathy (PDCI)
  • Friedreich's ataxia

Romberg test and cerebellar function

The Romberg test is not a test to assess cerebellar function. Patients with cerebellar ataxia will be unable to keep their balance with their eyes open so that we will not be able to pass the first stage of the Romberg test and no patient with cerebellar ataxia will be described as having a positive Romberg test.

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