What is the safe observation period for seizure recurrence in pediatric emergency departments?

•Approximately one out of every four seizure patients experience seizure recurrence in the emergency department.•A febrile seizure, cluster seizures, structural abnormalities and not receiving benzodiazepine therapy are risk factors.•Most seizure recurrences occur within the first 6 hours regardless of risk factors.•The first six hours of observation seem to be enough for acute seizure recurrence.