[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Clinical exam](https://durgical.com/en/clinical-exam/) › [Nervous system](https://durgical.com/en/clinical-exam/#a-neuro) › Romberg test [Clinical exam](https://durgical.com/en/clinical-exam/) · [Nervous system](https://durgical.com/en/clinical-exam/#a-neuro) # Romberg test - Maneuver The patient stands with the feet together and closes the eyes; losing balance means position sense is failing. Updated 2026-11-01 **See it in 3D:** [Spinal cord](https://durgical.com/en/anatomy/spinal-cord/) · [Cerebellum](https://durgical.com/en/anatomy/anterior-quadrangular-lobule/) · [Dorsal root ganglia](https://durgical.com/en/anatomy/spinal-ganglion/) · [Vestibulocochlear nerve (VIII)](https://durgical.com/en/anatomy/vestibulocochlear-nerve/) ## Key points - Positive Romberg = steady with eyes open, unsteady with eyes closed. - It means loss of proprioception (dorsal columns or large-fibre neuropathy) or, at times, a vestibular disorder. - Classic causes: vitamin B12 deficiency, tabes dorsalis (tertiary syphilis), diabetic neuropathy. - In cerebellar ataxia the patient is unsteady even with the eyes open: this is not read as a positive Romberg. - Safety: the examiner stands close with the arms ready to catch the patient. ## What it is Standing uses three inputs: vision, the vestibular system and proprioception. The Romberg test removes vision: if balance depends on the eyes because proprioception is failing, the patient sways or falls on closing them. It is positive in sensory ataxia and is not a cerebellar test, because a patient with cerebellar disease is already unsteady with the eyes open. ## The anatomy it tests - Tests proprioception that ascends in the dorsal columns of the cord from the dorsal root ganglion. - The spinocerebellar tracts and the vestibular system (cranial nerve VIII) also contribute. - The cerebellum integrates these signals; damage to it causes unsteadiness even with the eyes open. ## How to do it - Explain the test and remove the shoes; the examiner stands beside or behind the patient, very close. - Ask the patient to stand with the feet together and the arms at the sides or crossed. - First watch for about 30 seconds with the eyes open. - Then ask the patient to close the eyes and watch for another 30 to 60 seconds. - Record whether sway increases, whether the patient steps to avoid falling, or falls. - A more sensitive variant: standing in tandem (one foot in front of the other) with the eyes closed. ## What a positive result means - Positive: falls or sways clearly more with the eyes closed than open; suggests sensory ataxia. - Dorsal columns: subacute combined degeneration from B12 deficiency, tabes dorsalis, posterior cord compression. - Peripheral nerve: diabetic, alcoholic or chemotherapy-related polyneuropathy. - Falling to the same side with vertigo suggests a vestibular lesion on that side. - A negative Romberg does not rule out a mild neuropathy. ## Usefulness and limits - Simple and useful at the bedside, but interpretation is subjective. - Anxiety or fear of falling increases sway without a real lesion. - It does not replace testing vibration and position sense. ## Test yourself Think of the answer, then tap the question to see it. ## What counts as a positive Romberg test? The patient stays steady with the eyes open but sways a lot or falls on closing them. ## Why is the Romberg not a cerebellar test? A patient with a cerebellar lesion is already unsteady with the eyes open; removing vision changes balance little. ## Which vitamin deficiency causes a positive Romberg through dorsal column damage? Vitamin B12 deficiency, which causes subacute combined degeneration of the cord. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/clinical-exam/romberg-test/) ## See it in 3D The structures of Durgical's 3D anatomy where it is found. - [Spinal cord](https://durgical.com/en/anatomy/spinal-cord/) - [Cerebellum](https://durgical.com/en/anatomy/anterior-quadrangular-lobule/) - [Dorsal root ganglia](https://durgical.com/en/anatomy/spinal-ganglion/) - [Vestibulocochlear nerve (VIII)](https://durgical.com/en/anatomy/vestibulocochlear-nerve/) ## Related - [Sensory examination: modalities and dermatomes](https://durgical.com/en/clinical-exam/sensory-examination-modalities-and-dermatomes/) - [Cerebellar tests: finger–nose, heel–shin and rapid alternating movements](https://durgical.com/en/clinical-exam/cerebellar-tests-finger-nose-heel-shin-and-rapid-alternating-movements/) - [Abnormal gaits: hemiparetic, parkinsonian, ataxic, steppage, waddling](https://durgical.com/en/clinical-exam/abnormal-gaits-hemiparetic-parkinsonian-ataxic-steppage-waddling/) - [Cerebellar syndrome](https://durgical.com/en/clinical-exam/cerebellar-syndrome/) ## Related conditions - [Peripheral neuropathy (diabetic and other)](https://durgical.com/en/conditions/peripheral-neuropathy/) - [Megaloblastic anaemia (B12 or folate deficiency)](https://durgical.com/en/conditions/megaloblastic-anaemia/) - [Syphilis](https://durgical.com/en/conditions/syphilis/) - [Benign paroxysmal positional vertigo (BPPV)](https://durgical.com/en/conditions/benign-paroxysmal-positional-vertigo/) [← All of the clinical exam](https://durgical.com/en/clinical-exam/) Educational content on the clinical exam; it is learned and practised under supervision. It does not replace assessment by a health professional and is not for self-diagnosis. Sources: [16.5 The Coordination and Gait Exams](https://openstax.org/books/anatomy-and-physiology-2e/pages/16-5-the-coordination-and-gait-exams) (OpenStax, Anatomy and Physiology 2e, 2022); [16.4 The Sensory and Motor Exams](https://openstax.org/books/anatomy-and-physiology-2e/pages/16-4-the-sensory-and-motor-exams) (OpenStax, Anatomy and Physiology 2e, 2022); [How To Assess Sensation](https://www.msdmanuals.com/professional/neurologic-disorders/neurologic-examination/how-to-assess-sensation) (MSD Manual Professional Edition, 2024). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/clinical-exam/romberg-test/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/clinical-exam/romberg-test/