Dizziness can be a sign of a serious medical condition. If you feel dizzy or have a child who complains of dizziness, it's important to go to the doctor for a complete medical exam. One of the first things the physician or pediatrician will do is a Romberg balance test. Here's what you need to know about the Romberg test, possible diagnoses, other diagnostic tests, and who you may be referred to for further evaluation. 

Romberg Balance Test 

The Romberg balance test is done by standing with your feet together side by side, one foot in front of the other, or semi-tandem, while having your arms reached out to the sides or crossed in front of you. When in position, you will be asked to close your eyes. The physician will then watch your body to see if you sway. The test is done to study how or if three sensory systems—proprioception, vision, and vestibular sense—work together appropriately, which requires the spinal cord's dorsal columns to be healthy and functioning properly.

Another thing you will be asked to do while your eyes are closed is to touch the pointer finger of one hand to your nose. Failure to do this correctly with no signs of swaying can signify a cerebellar dysfunction. Failure of the Romberg balance test will necessitate a referral to a neurosurgeon or a neurologist for further evaluation, which will include MRI imaging of the brain and spine. Possible medical conditions of concern in which these specialists can evaluate include a brain tumor, head trauma, multiple sclerosis, stroke, cerebral palsy, Chiari malformation, and retroflexed odontoid. 

Ruling Out Possibilities

Before your visit with a neurosurgeon or neurologist, it will be crucial for your physician or pediatrician to rule out any other possible causes for the failed Romberg balance test, which includes vitamin deficiencies in B-12, E, or thiamine. Dehydration, celiac disease, toxic reactions, infections, and paraneoplastic syndromes should also be ruled out before a visit to a neuro specialist. Many of these possibilities can be tested with a complete blood workup and a study of your medical history to determine whether or not there have been missed signs or symptoms that may explain your current dizziness. 

Additionally, you may be scheduled for an MRI before your neurosurgeon or neurologist visit. That way, he or she will already have imaging to look at before your medical examination with them. It's important to schedule the MRI with the specialist's preferred MRI imaging provider so they are able to easily obtain a copy of the imaging.