North American Registry of Midwives (NARM) Practice Exam

Which of the following is NOT considered a sign of subtle seizures in newborns?

1. Sucking motions

2. Chewing

3. Bicycling of limbs

4. Extreme lethargy

The correct answer is: Extreme lethargy

Extreme lethargy is not considered a sign of subtle seizures in newborns. Subtle seizures can present with changes in muscle tone or movement that may be more reflexive or rhythmic rather than indicative of a lack of responsiveness. On the other hand, signs such as sucking motions, chewing, and bicycling of limbs are recognized behaviors that could indicate subtle seizure activity. These movements may be mistaken for normal reflexes or behaviors but can occur during seizure episodes. The presence of these specific movements in the context of altered awareness or responsiveness is what differentiates them as seizure manifestations rather than generalized lethargy, which suggests a more significant impairment of the central nervous system and could reflect other underlying issues or conditions, rather than the specific characteristics associated with seizures in this context.