Rhomberg Sign: Test, Significance, and Clinical Interpretation
The Romberg test (often misspelled "Rhomberg") assesses proprioceptive and vestibular contributions to balance. Procedure:
- Patient stands feet together, eyes open → observe stability.
- Eyes closed → observe for swaying/falling.
Positive Romberg: Marked increase in sway or fall with eyes closed indicates proprioceptive (dorsal column) dysfunction (e.g., peripheral neuropathy, posterior cord syndrome, B12 deficiency, tabes dorsalis). Cerebellar or vestibular lesions cause swaying with eyes open that does not significantly worsen with closure.
It is a bedside sign, not a reflex. Always interpret in clinical context with full neurologic exam.
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