Symptomatic febrile seizure: The child has a preexisting neurologic abnormality or acute illness. [6] Although the outlook for most children with symptomatic seizures or those associated with epilepsy is generally good, seizures may signal a potentially serious underlying systemic or central nervous system (CNS) disorder that requires thorough investigation and management. [1] Children may have behaviors that are easily mistaken for epileptic Seizures but are not , these include breath-holding spells ,bed wetting ,night terrors ,tics. [7] Gastroesophageal reflux may cause arching of the back and twisting of the head to the side in infants, which may be mistaken for tonic-clonic seizures[7], misdiagnosis is frequent (occurring in about 5 to 30% of cases) [8] .