Abstract
Early developmental delay and progressive neurological symptoms are red flags when evaluating infants in neurology clinics. Early assessment and management are essential to improve outcomes, with genetic testing being a cornerstone. Even if initial genetic results were not suggestive, revisiting the reported variant and comparing it to the newly published reports of different phenotypes helps establish the clinical diagnosis, as the authors report in this case of a 17-month-old child who presented with global developmental delay and hypotonia and was found to have Alanyl-tRNA Synthetase 2 (AARS2) gene mutation that was deemed as variant of uncertain significance but now is believed to be pathogenic and responsible for her evolving clinical manifestations.