Awaiting Diagnosis

[juliesmile]

Prometheus,

what's the Romberg sign and what does a positive test mean.

 

[CindyM]

I just looked it up. It is a test similar to the one they give for people suspected of driving while under the influence. Basically, you try to walk a straight line with your eyes closed. Google says a positive Romberg sign could indicate CIPD or one of the Peripheral neuropathies.

 

[prometheus]

Romberg

I may have used the wrong term. The test I'm thinking of is when I stand up straight and close my eyes. I am unable to maintain my balance with my eyes closed as opposed to being able to with them open. As soon as I close my eyes I start to sway and then fall down. I think it is also administered by the police. Maybe I used the wrong term?

 

[olly]

that is correct, but in pls balance is impaired, and the motor pathways run through the cerebellum so a umn lesion there will cause balance problems. i too failed that test.
but also if in mnd you have difficulty walking with eyes open it's obvious you can't with them shut!.:neutral:

 

[olly]

sorry i was talking about walking one the other standing still is to test for ataxia also a cerebellum area.

 

[olly]

Romberg Test
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Ask the patient to stand with their feet together (touching each other). Then ask the patient to close their eyes. Remain close at hand in case the patient begins to sway or fall.

67. Romberg Test



What is Being Tested?

With the eyes open, three sensory systems provide input to the cerebellum to maintain truncal stability. These are vision, proprioception, and vestibular sense. If there is a mild lesion in the vestibular or proprioception systems, the patient is usually able to compensate with the eyes open. When the patient closes their eyes, however, visual input is removed and instability can be brought out. If there is a more severe proprioceptive or vestibular lesion, or if there is a midline cerebellar lesion causing truncal instability, the patient will be unable to maintain this position even with their eyes open. Note that instability can also be seen with lesions in other parts of the nervous system such as the upper or lower motor neurons or the basal ganglia, so these should be tested for separately in other parts of the exam.

 

[prometheus]

I'm not too keen on anatomy, but it sounds like this sign would not be typical of ALS right? Maybe this is why the MD is thinking Multiple System Atrophy?

 

[olly]

if you look it says it can be caused by umn/lmn lesion.
those with predominatly umn symptoms usually have a balance problem, ido so does geo and many others .
by the way when i asked if you were looney i was only joking, just my british dry sence of humour lol.:-D

 

[prometheus]

I didn't see that but it makes sense. Don't worry about the humor.. mine is dry too.