Which of the following signs may indicate the presence of subtle seizures in a neonate?

Horizontal deviation of the eyes is often associated with subtle seizures in neonates. This phenomenon, known as ocular roving or eye deviation, can manifest as one or both eyes drifting laterally. It is crucial in identifying seizures because subtle seizures in neonates can be difficult to detect, and abnormalities in eye movement can be a telling sign. Recognizing such atypical eye behavior can help clinicians intervene promptly and effectively.

On the other hand, stupor typically reflects altered consciousness rather than specific seizure activity. Mild hypotonia may be present in various conditions affecting a neonate but is not a definitive sign of seizure activity. Cyanotic episodes often indicate respiratory distress or other underlying health issues rather than seizures.