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Objective To analyze the clinical characteristics and treatment of young epileptic patients with febrile seizure (FS) history, and to investigate the relationship between febrile seizure and epileptic attack in adolescents. Methods The clinical data of epileptic patients with the onset age < 18 from Chinese PLA General Hospital during October 2002 to July 2010 and their epileptic etiology were collected and retrospectively analyzed. The clinical characteristics, accessory examination results and treatment of these patients with simple febrile seizure (SFS) and complex febrile seizure (CFS) were analyzed. Results According to diagnostic criteria of epilepsy, 2699 cases (58.74%) with the onset age < 18 were collected from 4595 cases, including 1573 cases (58.28%) with idiopathic epilepsy and 1126 cases (41.72%) with secondary epilepsy. Febrile seizure (297 cases, 26.38%) was the main cause of adolescent secondary epilepsy, including simple febrile seizure in 200 cases and complex febrile seizure in 97 cases. Partial seizure was the main attack type (X2 = 4.933, P = 0.026). The abnormal rate of neuroimaging (X2 = 38.083, P = 0.000) and neuroelectrophysiological ( X2= 4.469, P = 0.035) in patients with febrile seizure history were obviously increased. The rate of antiepileptic drugs (AEDs) therapy was 66.67% (198/297), and patients who had taken traditional antiepileptic drugs accounted for 70.20% (139/198). Conclusions The causes of secondary epilepsy in adolescents were various, with febrile seizure as the major one. Partial seizure was the main attack type in both simple febrile seizure and complex febrile seizure. Traditional antiepileptic drugs therapy was chosen more. However, nearly one-third patients took no medicine or took their medicine irregularly. [ABSTRACT FROM AUTHOR]