A 9-month-old boy with right-hand preference

We present a case of a 9-month-old boy with a history of unequal hand movements, right-hand preference on physical examination, and cortical dysplasia on brain magnetic resonance imaging who was eventually diagnosed with cerebral palsy (CP). Although spasticity involving one or more limbs is the most common neurologic sign of CP, there can be a variety of other presenting symptoms including early hand preference, hypotonia, and oral motor dysfunction. In addition, traditional risk factors of premature birth and intrapartum complications are not always present. Given the wide clinical spectrum of CP, it is important for primary care providers to maintain a high index of suspicion to ensure appropriate diagnosis and early access to interventions.