The most common forms of paediatric vertigo are usually represented by benign causes. The occurrence of vertigo may nonetheless represent the onset of an underlying neurological disease, even without other neurological signs. The paper presents the case of a teenager with acute/subacute onset of vertigo and nausea; the examination revealed horizontal nystagmus with clinical features suggesting a peripheral form and minimal coordination defect. However, the clinical picture and persistence of symptoms led to perform brain imaging (MRI), which showed inflammatory demyelinating lesions with no signs of chronicity. These signs allowed a clinically isolated syndrome belonging to the spectrum of multiple sclerosis related disorders to be diagnosed.