Which finding represents a positive Romberg sign?

• A. Dark spots in the visual fields during the confrontation visual field test.
• B. When the patient closes the eyes and stands with their feet together they start to lose their balance and sway back and forth.
• C. The patient's sign and symptoms increase when exposed to hot temperatures.
• D. Pill rolling tremor of the fingers and hands.

Answer: (B)

Romberg sign assesses sense of proprioception and dorsal column function for balance. When a person stands with feet together and eyes closed, they rely on their proprioceptive input to stay upright. If balance deteriorates—losing balance or swaying significantly—without visual input, it indicates a proprioceptive or sensory ataxia.

The described finding, where the patient closes the eyes and stands with feet together and begins to lose balance and sway back and forth, is exactly this positive Romberg sign. It demonstrates dependence on vision to compensate for impaired proprioception.

Visual field defects, heat-exacerbated symptoms, and parkinsonian tremor reflect other issues (visual pathways, Uhthoff phenomenon or MS, and Parkinson disease, respectively) and do not describe the balance test response that defines a positive Romberg sign.