Which of the following is a common etiology of neonatal seizures?

• A. Hypoxic-ischemic encephalopathy
• B. Intracranial hemorrhage
• C. Metabolic disturbances
• D. All of the above

Answer: (D)

Neonatal seizures typically arise from problems that make the immature brain more likely to fire synchronously. The most common contributors are injury from insufficient oxygen around birth (hypoxic-ischemic encephalopathy), bleeding within or around the brain (intracranial hemorrhage), and metabolic disturbances such as low blood sugar, calcium or magnesium abnormalities, or electrolyte imbalances. Each of these can irritate or disrupt neuronal networks enough to provoke seizures in newborns. Because all three are frequently seen as causes in neonates with seizures, the option that includes all of them best reflects the common etiologies. In real-world evaluation, clinicians look for evidence of perinatal hypoxia, use imaging to detect hemorrhage or other brain injury, and rapidly assess metabolic status with labs for glucose, calcium, electrolytes, and signs of infection, addressing each potential contributor to the seizure burden.