A positive Romberg test indicates loss of balance, with ataxia that is sensory in nature. Which option best reflects this interpretation?

• A. Loss of balance, ataxia is sensory in nature
• B. Cerebellar ataxia
• C. Muscle weakness
• D. Visual impairment

Answer: (A)

A positive Romberg test points to a failure in the proprioceptive (sensory) pathways that help you sense limb position. When balance becomes unstable and worsens with the eyes closed, it shows the person is relying on vision to compensate for lost proprioception, which is classic sensory ataxia. This fits the description of balance loss with ataxia that is sensory in nature.

In contrast, cerebellar ataxia stems from problems in the cerebellum and tends to produce ataxia that is not solely dependent on sensory input; patients often have limb incoordination, intention tremor, and dysmetria, and the Romberg sign is not the defining feature. Muscle weakness causes instability due to reduced force, not true ataxia from sensory loss. Visual impairment can disrupt balance, but the Romberg pattern specifically highlights proprioceptive failure when vision is removed, rather than a primary visual deficit.