patient is at first presentation, the greater the likelihood of recurrence In addition, recurrences are more likely to recur in patients with lower temperatures on presentation of their first seizure (lower than 40°C) and shorter duration of fever before the seizure (less than 24 hours) and in patients with a family history of febrile seizures Most recurrences (75%) will happen within year The exact risk of developing epilepsy after a febrile seizure is unknown, but most studies indicate that it is less than 5% Risk factors for developing epilepsy after a febrile seizure include abnormal development before the episode, a family history of afebrile seizures, and a complex first febrile seizure; without any of these risk factors, the risk of developing epilepsy is approximately 1%, which is almost the same risk as in the general population The treatment of a patient who presents with a febrile seizure is nearly identical to that for other seizure types The primary goal is the establishment of a clear airway; secondary efforts are then directed at the termination of the seizure and concurrent lowering of body temperature However, because most febrile seizures are brief in duration, the typical patient who presents for the evaluation of a febrile seizure is no longer seizing upon arrival to the ED In those instances, if the history is consistent with a simple febrile seizure, the patient has no stigmata of a CNS infection, and the patient’s neurologic examination is completely normal (other than the patient may be postictal or slightly hyperreflexive), further evaluation for the cause of the seizure is unnecessary As such, routine laboratory studies are not recommended for the patient with a simple febrile seizure While seizure may be the first manifestation of meningitis, LP is only indicated for children in whom meningitis is clinically suspected and it is no longer recommended routinely Similarly, routine neuroimaging or EEG screening is not recommended for the patient with a first-time simple febrile seizure However, the evaluation should focus on the possible cause of the fever Outpatient EEG is performed in some institutions for patients with complex febrile seizure While complex febrile seizures are associated with a slightly higher risk of subsequent epilepsy, the predictive value of these EEG studies and their yield on management changes remains controversial A patient who has had a febrile seizure and is well appearing and back to baseline may be safely discharged to home Parents should be reassured that febrile seizures are common and that most patients have no further episodes They need to be cautioned that a recurrence may happen and should be given simple instructions on what to should another seizure occur and indications for returning for evaluation They can also be instructed on the proper use of antipyretics, even though studies have failed to demonstrate that this is effective