Romberg Test

Definition

A standard maneuver in a neurological exam designed to assess mechanisms mediating balance which involves having the patient stand with feet together and eyes closed.

Current Knowledge

Balance or equilibrium when standing is primarily mediated by the cerebellum. However, to maintain balance, the cerebellum needs sensory input from vision, the vestibular system, and/or proprioceptive feedback from the lower extremities. In theory, when intact, the cerebellum can maintain postural stability if at least two of these three sensory systems are functioning properly, although disruption of the vestibular system alone can potentially result in significant unsteadiness. Once it has been established that the patient can maintain balance by standing with the feet together and the eyes open (a test of the integrity of the vermis of the cerebellum), the patient is asked to maintain the same stance but now with the eyes closed. If the patient has marked difficulty in maintaining balance...