Which finding is most closely associated with posterior column damage causing sensory ataxia?

• A. Posterior column damage
• B. Cerebellar damage
• C. Basal ganglia damage
• D. Positive Romberg sign

Answer: (D)

Proprioceptive input from the dorsal (posterior) columns is essential for steady balance when visual input is unavailable. Damage to these pathways leads to sensory ataxia, where coordination relies on intact somatosensory feedback. The Romberg test isolates this by having the patient stand with feet together and eyes closed; without vision to compensate for the lost proprioception, the person would sway or fall, yielding a positive Romberg sign. This sign is a hallmark of sensory ataxia due to posterior column pathology.

Cerebellar damage can cause ataxia, but the underlying problem is impaired coordination rather than a loss of proprioceptive feedback, so the Romberg sign is typically not positive. Basal ganglia damage produces movement disorders rather than sensory loss affecting balance.