Key Clinical MessageWe report a case of a Brazilian child born in 2011 with congenital Zika syndrome phenotype. Zika virus (ZIKV) may have been circulating in Brazil more than 4 years before the outbreak. ZIKV infection might be considered in children with this phenotype even without known circulation of ZIKV.

Children with congenital Zika syndrome should consistently be described as having cerebral palsy when meeting the criteria for this diagnosis.n Having access to cerebral palsy-based services will help families and health care professionals in their rehabilitation approaches for children with congenital Zika syndrome.Resumo em português no final do artigo.