question about Romberg's sign

[lydia]

Quick question:

Romberg's sign is when you can stand with feet close together and eyes open just fine, but close your eyes and... you sway or do you actually have to fall? Different sources say different things...

What is the significance, if any, of being able to walk heel to toe with eyes open and NOT being able to do it with eyes closed? Really, can ANYONE do it with their eyes closed?

Lydia

 

[planningguy]

Yeah, finding the answer can especially be troubling if you rely on the Wikipedia article that actually says that says both, "A positive sign is noted when a swaying, sometimes irregular swaying and even toppling over occurs," and, "Romberg's test is positive if, and only if, the following two conditions are both met: 1. The patient can stand with the eyes open; and 2. The patient falls when the eyes are closed."

From the examples I have seen, the examiner will not actually let the patient fall, but will let them sway to the point where it is obvious that they are having trouble staying on their feet. My own Romberg was negative, so I don't know how far my neuro would have let me go. I'd like to believe that he's a nice guy who's scared of a malpractice lawsuit.

Robert

 

[lydia]

heel to toe with eyes closed

Thanks Planningguy,

I am frustrated that I can't find out what it is, really-I am browsing neurology textbooks at 2am, how sad is that. I know that I sway with eyes closed, a little to alot; depends I think for me on time of day. So my response standing still is probably not that illuminating, BUT without a doubt, as soon as I try to take a step with eyes closed, all hell breaks out. But maybe that is supposed to be difficult? My neuro did not ask me to walk heel to toe with my eyes closed, do they ever? I don't want to waste energy getting worked up over something that no one can do anyways, but all my friends are sleeping and I will have to wait until tomorrow to test them all...

I have been following your story and wanted to let you know my thoughts are with you and I wish you the best of luck.

Lydia

 

[planningguy]

How are things out Buffalo way? I went to grad school in Albany, and had a handful of friends from Buffalo.

I would not stress it too much. If you can stay on your feet with your eyes closed you are probably in decent shape. There are a number of things that can cause you to be slightly unsteady on your feet with your eyes closed (including congestion, inner ear trouble, etc.). Keep in mind that all of these tests are merely pieces to a puzzle that a neuro is trying to evaluate.

Certainly don't worry about trying to walk anywhere with your eyes shut. You're not going to see a test that involves that. Movement without a visual reference point throws everyone for a loop. Haven't you ever played the blindfold game where you have to guide someone through a room or outside without them being able to see anything? Lots of swaying and stumbling.

Take care, and get some rest.

Robert

 

[olly]

hi

i know i was posative for both tests.
i start to fall straight away if i try to stand with my eyes shut,they have to be ready to catch me.
i can not take one step with my eyes open in the heal to toe test without going over.
i even failed in the nose test and were you have to touch the neuro's finger turn your hand round back to you then touch there finger again as fast as you can.
these could interpret ataxia but inco-ordination is a mnd symptom.
my co-ordination is allover the place,having clonus and spasms does not help either.
i am having pt at the moment and some of the exercises are to try and help my balance.
one is trying to stand on one foot without assistance,my best is 3seconds and my pt is at the back of me ready to catch me.

when do you go back and see your neuro lydia? i really hope you re-consider taking someone with you,is there a relative or friend you can confide in to go with you?
please don't try to cope on your own,you need support.
take good care.
caroline:-D

 

[lydia]

hello

Hi Olly,

I go back to neuro two weeks from today. I am going to wait and see how this plays out before I let others in. My friends can be partitioned into two categories right now: those with tremendous joy and happiness happening (and who wants to be responsible for raining on their parade), and those with heartbreaking sorrow (and how can you heap more worry on top of that...) So I can take it alone for the time being; especially if it all turns out to be nothing. Like I said before, I really do feel "detached". I have been so busy with buying a house and moving that it is only really in the past week or so that I have allowed myself to obsessively troll the internet, read this forum and the PD forums, etc. Plus work beckons as the semester has started. And besides, I can always post to here; a definite comfort.

Your balance issues sound awful, I'm sorry! How do you manage in the shower, if you don't mind my asking? Did you notice how it all started? I don't know when I started to avoid crowded hallways and stairwells, but I go to great lengths to avoid being jostled. It sends me flying. Even my new lawn is treacherous to walk across. Can only wear sensible shoes now.

My extended "experiment" last night from what I discovered is called the "sharpened romberg" is still on my mind. Standing with eyes closed in heel-to-toe was difficult enough (sharpened romberg), but even to take one step forward with eyes shut (that was my creative "extension")...how can one not be able to take one lousy step? I think I will have some fun with the camcorder later. Perhaps add some music. Could be the latest dance craze.

Lydia

Planningguy, well Buffalo is....Buffalo. Lots of drama in the schools and political areana. Still pretty scarred from the infamous October Storm.

 

[olly]

hi lydia

you sound like a emotionally strong level headed lady to me,but we all need support.
i am glad you are here(if you know what i mean),there are plenty of us here to give you any support you need.
i do have grab rails fitted in my shower but i prefer to use the bath,its much safer.
though i do have hypotension and it can drop suddenly and i blackout.
this happened once when i tried to get out of the bath,my son heard the bang and had to rush to help me.
thankfully i had put my towel round me and fastened it before i blacked out,my son found me slumped half in/half out the bath unconscious.
thankfully i only got bruising.
i know what you mean about crowded places,it makes you more jumpy and on edge.
this is not due to bad nerves but the over active reflexes,like being more jumpy with sudden or loud noises and is common in pls.
my uncle has pd,he is 67yrs old and has had it many years and is now in a bad way.
also my dad has possible altziemers,he goes back for his ct results in a few weeks.
there seems to be more and more people,especially under 40 having neurological illnesses. makes you think why.
we each have our problems to deal with but to show a little support to others does not take alot of effort.
take good care of yourself.
caroline:-D
ps, i have got high heeled shoes packed away,i have not been able to wear heels for some years now but can't bare to part with them.

 

[brendapals]

hey to lydia and caroline,

I have to admit I'm a little scared to try to do the Romberg's test while I am at work-on a tile floor! But I will try it again at home tonight. I know I passed it just fine at my last clinic visit on 7/3/08.

And on the 2 different groups of friends topic-I have the ones that are supportive in every way they know how to be, want to help me clean out my closets, declutter my house, etc.....then the ones that never call, don't want to admit that I even have ALS, and can't believe that I'm still working, going to school, raising my children, and everything else!

It's just amazing, and I truly enjoy the bunch of friends I've made on here, in a relatively short time!

to all of us,
Keep the faith,
brenda

 

[olly]

hi brenda

i know what you mean about friends,my best friend of 35yrs (we met at nursery school) never calls or see's me any more.
then other friends ask me to go places with them but it's either too far away or means getting back late at night and i have to tell them i can't.
they don't understand i get tired easily,need to go to bed by 9pm just to let my muscles relax for a couple of hours before i can sleep.
travelling is a nightmare as i just completley stiffen up with the spasms after sitting in a car for an hour,so i avoid days out.
you sound like you are doing well,i suspect your not really as to others things are not what they appear to be.
we can look ok ,seem to cope ok but really we are not,people can not always see the pain. i know i have learn't to cope with it so it's not always obvious,but its there.
i am glad you have some friends you can rely on and you will find many more here.
take good care.
caroline:-D