67. Romberg Test

What is Being Tested?

With the eyes open, three sensory systems provide input to the cerebellum to maintain truncal stability: vision, proprioception, and vestibular sense. If there is a mild lesion in the vestibular or proprioception system, when the eyes are open the patient is usually able to compensate and remain stable. When the patient closes their eyes, however, visual input is removed and instability can be brought out. If there is a more severe proprioceptive or vestibular lesion or if there is a midline cerebellar lesion causing truncal instability, the patient will be unable to maintain this position even with their eyes open.

Note that instability can also be seen with lesions in other parts of the nervous system, such as upper or lower motor neurons or the basal ganglia, so these other systems should be tested separately in the remainder of the exam.