García-Pastor C, Álvarez-Solís GA

Language: Spanish
References: 13
Page: 31-35
PDF size: 276.76 Kb.

ABSTRACT

The Romberg test is a neurological bedside or office evaluation, searching for sensorial ataxia as etiology in patients suffering of disequilibrium or gait disorders. This test has a high value if it is performed in a meticulous way and its interpretation is adequate; unfortunately, it is often misinterpreted. This must be included in every neurological exam, especially in those patients with dizziness, clumsiness, bobbing and frequent falls. A positive Romberg test is observed in proprioceptive disorders. Their high clinical values depend on a correct performance and interpretation. Some other conditions could show bobbing while perform this test, however is possible to do a differential diagnosis: labyrinthine disorders have a latency between eyes closing time and totting, besides imbalance always is ipsilateral to affected vestibule. In cerebellar disorders, disequilibrium is evident before eyes closing when the patient try to stand with feet close. On the other hand, a true Romberg sign refers to those patients standing up, with feet joined together and that show immediately after closing eyes, intense and multidirectional standing imbalance. H.M. Romberg is known as the first medical doctor that brought order to neurological science. He made many contributions, some of the most important is the original description of achondroplasia, facial hemiatrophy syndrome and pupillary signs in chronic syphilis, but overall sensorial ataxia test. He wrote the first organized neurological book.

REFERENCES

1. Pearce JM. Romberg and his sign. Eur Neurol 2005; 53: 210-13.

2. Da Mota GM. Neuronosology. Historical remarks. Arq Neuropsiquiatr 2011; 69: 559-62.

3. Housman B, Bellary S, Walters A, Mirzayan N, Tubbs R, Loukas M. Moritz Heinrich Romberg (1795-1893): early founder of neurology. Clin Anat 2012 [Epub ahead of print].

4. Lanska DJ, Goetz CG. Romberg’s sign: development, adoption, and adaptation in the 19th century. Neurology 2000; 55: 1201-6.

5. Gait and Station en Campbell W. De Jongs the neurologic examination. Lippincott Williams & Wilkins. 6th Ed. 2005.

6. General Sensory Systemsen Kiernan JA. (eds) Barr’s The human nervous system. An anatomical viewpoint. 10th Ed. Ed. Lippincontt Williams and Wilkins; 2014. ISBN 978-1-4511-7327-

7. p. 341-63. 7. Lanska DJ. The Romberg sign and early instruments for measuring postural sway. Semin Neurol 2002; 22: 409-18.

8. Gordon F, Birender B, Jayesh M, David C. Does walking change the Romberg sign? Eur Spine J 2009; 18: 1528-31.

9. Schiller F. Venery, the spinal cord, and tabes dorsalis before Romberg: the contribution of Ernst Horn. J Nerv Ment Dis 1976; 163: 1-9.

10. Lanska DJ. Nineteenth-century contributions to the mechanical recording of postural sway. Arch Neurol 2001; 58: 1147-50.

11. Herrero MJ, Lalanza-Lasheras JJ, Bernal- Rodriguez R, Parajuá-Pozo JL. La tabes dorsal de hoy y la de Alphonse Daudet. Rev Neurol 2008; 46: 765-6.

12. Schiffter R. Moritz Heinrich Romberg (1795-1873). J Neurol 2010; 257: 1409-10.

13. Moritz Heinrich Romberg (1795-1873). JAMA 1965; 193: 1119-20.