Orthostatic intolerance (OI) is characterized by the inability to maintain an upright posture without experiencing severe signs and symptoms, including hypotension, palpitations, light-headedness, pallor, fatigue, weakness, dizziness, impaired concentration, tremulousness, and nausea....
✦ The floor
Discussion
Signed responses from readers of the wire.
No actionable change for most audiology practices; this paradigm-shift proposal regarding ME/CFS-related disequilibrium is preliminary and directed primarily at internal medicine and autonomic disorder specialists.
Disequilibrium and dizziness are symptoms that bring ME/CFS patients into vestibular clinics, and evolving diagnostic frameworks may influence referral patterns and interdisciplinary care.
- 01Orthostatic intolerance in ME/CFS can present with disequilibrium, overlapping with vestibular complaints.
- 02Authors propose a paradigm shift in classifying and understanding ME/CFS subtypes involving small heart and/or disequilibrium.
- 03Content is a clinical update/opinion piece, not an original research study.
- 04Relevance to audiology is indirect, primarily through vestibular symptom overlap.
- 05No validated diagnostic or treatment protocol is established by this article.
Disequilibrium is a distinct and underrecognized symptom cluster within ME/CFS orthostatic intolerance.
opinionunclearA paradigm shift in understanding ME/CFS with small heart and/or disequilibrium is warranted.
opinionunclear- PMID
- 42591853
- DOI
- 10.3389/fmed.2026.1744154.
- Journal
- Frontiers in Medicine
- Publication type
- editorial
- Evidence level
- 5
- Population
- Patients with myalgic encephalomyelitis/chronic fatigue syndrome and orthostatic intolerance
- Intervention
- Conceptual reclassification of orthostatic intolerance subtypes in ME/CFS
Primary outcomes
Proposed paradigm shift in ME/CFS diagnostic classification including disequilibrium