Romberg's test is a simple bedside sensitive clinical test that pinpoints to sensory ataxia as the cause in a patient presenting with postural imbalance. As described above, the test is invaluable if carried out meticulously and interpreted cautiously. It must be carried out in all patients presenting with dizziness, imbalance, and falls. Sensory ataxia has a number of treatable etiologies. Needless to say that focused laboratory testing should be carried out in all cases to nail the cause and offer appropriate treatment.
Romberg's test is a commonly performed test during the neurological examination to evaluate the integrity of dorsal columns of the spinal cord. Moritz Heinrich von Romberg first described it in the early 19th century. It evolved from a symptom to a valuable clinical sign. It was classically described in patients with tabes dorsalis (neurosyphilis), but can be elicited in many conditions affecting proprioception. This simple test offers an important clue to the presence of pathology in the proprioceptive pathway and should be meticulously carried out during the neurological evaluation. Early detection of reversible causes is desirable as they may be remediable and their treatment can prevent permanent dysfunction and disability.
