Romberg
Now, we’ll test the Romberg sign. Now, the Romberg sign is an interesting sign, it tests the sensory input to the cerebellum, not the cerebellum itself. The cerebellum needs two out of three sensory inputs to function properly. Those three sensory inputs are vision, proprioception and vestibular apparatus. If you take away one of those, and the patient is able to stand, then you know that the other two sensory inputs must be intact. If the patient falls or wobbles significantly, then you know that the patient has a problem with either proprioception or vestibular apparatus, because we’re going to have him close his eyes. By definition, the Romberg sign is with the eyes closed.
-“Put your feet together, all the way.”
Now, if the patient starts wobbling now with the feet together and the eyes open, then you can’t say he had an abnormal Romberg sign. You say Romberg sign was not testable, patient failed with eyes opened. Now, have the eyes closed, and I’m standing here to make sure he doesn’t fall. He does not, he doesn’t even wobble.
-“Open your eyes.”
That means his proprioception is normal and his vestibular apparatus is normal.