Romberg Sign and neuromythology

摘要

I beg to differ with Professor Turner's suggestion that modern 'discerning' clinicians can omit Romberg's test from their repertoire. Medical students (and patients) frequently fail to appreciate the contribution of the pro-prioceptive sensory system to maintaining equilibrium. As a trainee at the Boston City Hospital, the Chief of Neurology was fond of impressing this on his residents by attaching vibrators to our Achilles' tendons and challenging us to remain standing with our eyes closed. The essential component of Romberg's test is the emergence of ataxia on eye closure. It is a reproducible and localisable sign if properly conducted, and a positive test exonerates the vermis from any role in contributing to ataxia. I encourage all neurologists to continue to teach this valuable sign and its anatomical basis to their students, arid to give due credit to Dr Romberg for bringing order to the assessment of gait.