Palaniappan, Rudrapathy, Sirimanna, Tony · International journal of pediatric otorhinolaryngology · 2002 · DOI
This study describes a 12-year-old boy with ME/CFS who experienced dizziness caused by a problem with the balance system in his inner ear (his left vestibular system). The doctors found that specific tests could identify this balance problem, and that exercises designed to help retrain the balance system were an effective treatment. This case suggests that some people with ME/CFS who have dizziness might benefit from checking their balance system and doing targeted exercises.
This study highlights an often-overlooked cause of dizziness in ME/CFS patients—peripheral vestibular dysfunction—which may be treatable through specialized rehabilitation. Recognition of vestibular involvement could improve quality of life for patients experiencing balance problems and vertigo. The recommendation for systematic vestibular assessment in ME/CFS populations could lead to better symptom management and more targeted treatment approaches.
This case report does not establish how common vestibular dysfunction is among ME/CFS patients, nor does it prove that peripheral vestibular failure is a primary feature of ME/CFS itself. The findings describe association in one patient and do not determine whether vestibular problems are a cause of CFS, a consequence of it, or a coincidental co-occurrence. Broader studies with larger sample sizes are needed to understand the prevalence and clinical significance of this finding.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Palaniappan, Rudrapathy & Sirimanna, Tony (2002). Peripheral vestibular dysfunction in chronic fatigue syndrome.. International journal of pediatric otorhinolaryngology. https://doi.org/10.1016/s0165-5876(02)00039-3
BibTeX
@article{mecfsatlas-palaniappan-2002-peripheral-vestibular,
author = {Palaniappan, Rudrapathy and Sirimanna, Tony},
title = {Peripheral vestibular dysfunction in chronic fatigue syndrome.},
journal = {International journal of pediatric otorhinolaryngology},
year = {2002},
doi = {10.1016/s0165-5876(02)00039-3},
note = {PubMed: 12020917},
url = {https://www.mecfsatlas.com/evidence/palaniappan-2002-peripheral-vestibular},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/palaniappan-2002-peripheral-vestibular
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