Skare, Thelma L, de Carvalho, Jozélio Freire, de Medeiros, Italo Roberto Torres et al. · Autoimmunity reviews · 2024 · DOI
This review examined hearing and balance problems (including hearing loss, tinnitus, dizziness, and vertigo) reported across multiple conditions including ME/CFS, fibromyalgia, and long COVID. Researchers searched medical literature from 1990 to 2024 and found that while hearing problems are common, balance problems are less frequently reported. The study suggests these symptoms may stem from immune system dysfunction affecting the inner ear.
This systematic review consolidates evidence that ear-related symptoms are widespread across a cluster of immune-mediated conditions including ME/CFS, highlighting a potentially underrecognized symptom domain. For ME/CFS patients experiencing hearing or balance problems, this work validates these symptoms as part of the disease spectrum and suggests clinical evaluation pathways. It also proposes shared pathophysiologic mechanisms that may advance understanding of these overlapping conditions.
This review does not establish causation or the relative prevalence of ear symptoms in ME/CFS specifically—findings are aggregated across heterogeneous populations with variable case definitions and symptom assessment methods. The study cannot determine which proposed mechanisms (viral, autoimmune, vascular, epigenetic) are primary versus secondary or most relevant to any individual condition. It also does not provide controlled comparison between ME/CFS and healthy populations or establish prognostic or treatment implications.
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
Skare, Thelma L, de Carvalho, Jozélio Freire, de Medeiros, Italo Roberto Torres, & Shoenfeld, Yehuda (2024). Ear abnormalities in chronic fatigue syndrome (CFS), fibromyalgia (FM), Coronavirus-19 infectious disease (COVID) and long-COVID syndrome (PCS), sick-building syndrome (SBS), post-orthostatic tachycardia syndrome (PoTS), and autoimmune/inflammatory syndrome induced by adjuvants (ASIA): A systematic review.. Autoimmunity reviews. https://doi.org/10.1016/j.autrev.2024.103606
BibTeX
@article{mecfsatlas-skare-2024-ear-abnormalities,
author = {Skare, Thelma L and de Carvalho, Jozélio Freire and de Medeiros, Italo Roberto Torres and Shoenfeld, Yehuda},
title = {Ear abnormalities in chronic fatigue syndrome (CFS), fibromyalgia (FM), Coronavirus-19 infectious disease (COVID) and long-COVID syndrome (PCS), sick-building syndrome (SBS), post-orthostatic tachycardia syndrome (PoTS), and autoimmune/inflammatory syndrome induced by adjuvants (ASIA): A systematic review.},
journal = {Autoimmunity reviews},
year = {2024},
doi = {10.1016/j.autrev.2024.103606},
note = {PubMed: 39209013},
url = {https://www.mecfsatlas.com/evidence/skare-2024-ear-abnormalities},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/skare-2024-ear-abnormalities
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