Prognosis of febrile convulsions: paper tiger or real jackal? Febrile seizures (FS) are the most common convulsive disorder in pediatrics, with an age of onset between 3 months and 5 years, sudden onset of convulsions at a body temperature above 38°C, excluding intracranial infections and other organic and metabolic diseases that cause convulsions, and without a previous history of febrile convulsions. The prevalence of febrile convulsions in childhood is 2%-5%, and there is often a family history of febrile convulsions with a clear genetic susceptibility. However, for the vast majority of parents, the main concern is the impact of each episode on the child’s intelligence and behavior, what is the long-term prognosis, and whether long-term treatment and prevention are needed? A large U.S. National Perinatal Collaborative research project followed 54,000 pregnant women and their children from 1959-1966 and found that the children with febrile convulsions did not differ in intelligence from other normal children at age 7. Another British prospective study of 16,000 children born the same week in April 1970 found no significant differences between the febrile convulsion group and the normal group at age 10 years in 102 assessments of academic, intellectual, and behavioral status. Therefore, long-term drug prophylaxis is not needed for such children, and targeted oral valium can be administered two days before the onset of fever to prevent convulsions. However, for children with febrile convulsions that develop within 1 year of age, the chances of developing epilepsy are much higher in children with partial-onset seizures and seizures lasting more than 15 minutes or more than 2 seizures within 24 hours. Because febrile convulsions can be an early manifestation of Dravet’s syndrome, they can also be a type of seizure with generalized epilepsy with febrile convulsions attached. Therefore, a detailed family history and, if necessary, early genetic testing are needed for early intervention and treatment.