If a patient loses balance with eyes closed when standing with feet together, this finding is most suggestive of which type of dysfunction?

If a patient loses balance with eyes closed when standing with feet together, this finding is most suggestive of which type of dysfunction?

• A. considered a normal finding
• B. suggestive of ataxia related to dorsal column disease
• C. suggestive of cerebellar ataxia
• D. corticospinal tract damage

Answer: (B)

The key idea is that maintaining balance without visual input relies on proprioception carried by the dorsal columns. When someone can stand with eyes open but loses balance with eyes closed, it points to sensory ataxia from a dorsal column dysfunction, because the proprioceptive feedback needed to position the body is impaired and vision can no longer compensate. This is why the finding described is most suggestive of dorsal column disease. In contrast, cerebellar ataxia tends to cause instability even with eyes open and is more about coordination than a lost position sense; corticospinal tract damage would primarily produce weakness and spasticity rather than a primary proprioceptive deficit. A normal finding would not show this drop in balance with eye closure.

The key idea is that maintaining balance without visual input relies on proprioception carried by the dorsal columns. When someone can stand with eyes open but loses balance with eyes closed, it points to sensory ataxia from a dorsal column dysfunction, because the proprioceptive feedback needed to position the body is impaired and vision can no longer compensate. This is why the finding described is most suggestive of dorsal column disease. In contrast, cerebellar ataxia tends to cause instability even with eyes open and is more about coordination than a lost position sense; corticospinal tract damage would primarily produce weakness and spasticity rather than a primary proprioceptive deficit. A normal finding would not show this drop in balance with eye closure.