Rombergism, Romberg’s Sign

Rombergism, Romberg’s Sign

Romberg’s sign is adjudged present (or positive) when there is a dramatic increase in unsteadiness, sometimes with falls, after eye closure in a patient standing comfortably (static Romberg’s test). Before asking the patient to close his or her eyes, it is advisable to position ones arms in such a way as to be able to catch the patient should they begin to fall.

Patients may fall forward immediately on eye closure ("sink sign"). These phenomena result from sensory ataxia (i.e., loss of proprioception from the feet), which occurs most commonly with posterior column spinal cord disease: Romberg’s sign may be seen in tabes dorsalis.
A modest increase in sway on closing the eyes may be seen in normal subjects, and patients with cerebellar ataxia, frontal lobe ataxia, and vestibular disorders (toward the side of the involved ear); on occasion these too may produce an increase in sway sufficient to cause falls. Hence, Romberg’s test is not specific. Posturography is an attempt to quantify the Romberg test.
Large amplitude sway without falling, due to the patient clutching hold of the physician, has been labeled "psychogenic Romberg’s sign", an indicator of functional stance impairment.
Heel-toe (tandem) walking along a straight line is sometimes known as the dynamic Romberg’s test.



Pearce JMS. Romberg’s sign. In: Pearce JMS. Fragments of neurological history. London: Imperial College Press, 2003: 373-374 


Cross References

Ataxia; Functional weakness and sensory disturbance; Proprioception; Tandem walking