The Gut–Brain Connection: An Atypical Presentation of Multiple Sclerosis in a Teenage Boy

A bstract Pediatric multiple sclerosis (MS) is a relatively rare but consequential demyelinating disorder with primarily central nervous system involvement. Diagnosis is based on clinical symptoms, imaging, and cerebrospinal fluid analysis to assess for dissemination of lesions across time and space using the McDonald criteria. It is uncommon for MS to present without central nervous system manifestations. This case highlights an atypical presentation of MS in a previously healthy 16-year-old male. The patient exhibited gastrointestinal symptoms consisting of intractable nausea and vomiting. While symptoms involving the alimentary tract are described in MS, to our knowledge, there are no reports of pediatric MS presenting solely with gastrointestinal manifestations without neurological disturbances. The intent of this report is to establish the significance of considering atypical presentations, particularly with gastrointestinal symptoms, in the diagnosis of demyelinating disorders. Early detection and treatment of pediatric MS may optimize health outcomes in these patients.