 Hello, good morning. This is Surya Grawalihar, junior resident from Vadodra SVKS Medical Institute. Today, my topic is MRI evaluation of epilepsy with clinical correlation. Epilepsy is the fourth most common non-promantic neurologic disorder. According to the Commission on Neuroimaging of the International League against Epilepsy, all the patients with epilepsy should undergo an MRI except those with very typical forms of primary generalized epilepsy or benign focal epilepsies of childhood with characteristic clinical features, early onset childhood epilepsy with occipital spikes and adequate response to any anti-epileptic drugs. The etiologies of epilepsy are varied and multifocal in various cases. Therefore, the investigation of the underlying causes of seizure will depend upon the clinical context in particularly the type of syndrome, age, types of seizures, associated diseases, presence or absence of progressive or static motor and cognitive dysfunction. In this contest in addition to EEG, neuroimaging techniques in particular MRI are the most important tools for determining the syndromic diagnosis and possible etiolodeoepilepsy. The most common causes of epilepsy are described here. They are such as messenger temporal sclerosis, infections like NCCS, neurosis, cirrhosis, tuberculoma, etyleptogenic tumors like meningioma, neuropytonia syndromes like tuberous sclerosis, developmental like hetropia, megastarosis, gliosis scars and others such as calcified granulomagis legion, cavernous hemangioma. The aims and objectives of this topic is to violate various causes of epilepsy on MRI brain using conventional and non-contrast MRI in conjunction with advanced MRI techniques such as MRI spectroscopy and verification and differentiation of different legions to evaluate the MRI features of various causes of epilepsy through an optimized epilepsy protocol with adequate spatial resolution and multi-planar reformation. The materials and methods used here are the study design is prospective observational study, sample size approximately 50 patients with the sign-in symptom of caesarepilepsy and other epilepsy disorders during the study period I have been followed. It is conducted as the SBCS Medical Institute, Vadodara, India. The study population was drawn from the patients who were referred to the department of radio diagnosis and collaboration with all the departments as well. The materials and procedures before commencing the study with an informed consent was taken from all the patients. All patients were handed at the same doctor to minimize the biasness. Inclusion criteria include who are presented with all the seizure or epilepsy for the MRI brain in the department of radio diagnosis irrespective of their age and gender. Exclusion criteria include patient not giving the informed concern, patient in which MRI is contraindicated such as patients with a pacemaker, metallic implants and aneurysmal cleavage, patients with a glossophobia. The study tool for this is 1.5 Tesla 16-channels MRI machine Phillips. The percentage of distribution of the cases based on ages 1 to 15 years includes 18%, 16 to 30 years include 42%, 1 to 45 years include 22%, 46 to 60 years include 10% and more than 60 years include 6%. On the basis of gender, male compromise of 66% and the female is of 34%. The male predominance is more as compared to the females. Distribution of cases based on MRI findings the most common include granulomatics, disease such as neurocystisercosis, tuberculoma, calcified granulomas, messenger temporal sclerosis and others as described in the table. Distribution of cases based on the type of epilepsy generalize tonic clothing includes 72%, partial includes 28%. Epilepsy is a chronic neurologic disorder characterized by spontaneous recurrent caesars. To most patients with epilepsy caused by generalized caesars respond to antipleptic drugs. One third of those with the partial caesars are resistant to antipleptic drugs. In the case surgical resection of the brain legion is often the only effective treatment. Patients presenting the caesars can have a wide range of MRI imaging modalities or abnormalities depending upon the etiology. Patients presented with caesars of varying duration ranging from few days to few months. Generalized tonic-clonic caesars was the most common clinical diagnosis considering to about 72% of the cases. Some of the common cases are being discussed here like granulomatics, disease, neurocystisercosis. Cystisercosis is a major health problem in several Asian countries. It is the cause of epilepsy in about up to 50% of Indian patients presenting with partial caesars. The most common location of NCC legion is brain parenchyma. Patients may have multiple legions at different stages of evolution. Colloidal vesicular stage, the dynastrolex. MR shows that the cyst fluid is highly hyperlinked to CSF on T1 weighted images. Dynastrolex appears hyperintense on slim. Moderative marks surrounding edema is present. Enhancement of the cyst wall is typically intense, serine-like and openly slightly shaggy. The next one is tuberculoma. It is the second most common manifestation of neuro tuberculosis, which is characterized by focal parenchyma. Inspection with the central t-18 necrosis. Legions with ISO or hyperintensity on T1 weighted images and central hyperintensity with the peripheral hyperintense ring on T2 weighted images. Categorizes it under under the solid caesating granuloma. Since cellular components appear brighter, it is slightly specific for the tuberculoma. Thus, it has been shown that T1 weighted MR imaging is superior to MRs in characterization to such legions. Calcified granulomatics legion, calcified granulomas are the most inflammatory response. They form as a result of chronic infection, mostly due to neurocystis suposis and more commonly due to tuberculosis in our country. Having a large number of patients with granulomast, granulomatics disease and a short history signifying that most patients are picked up in early course of disease. Messenger temporal sclerosis. It is the second most common substrate associated with epilepsy in this study. We found that architectural distortion of hippocampus of patients with hippocampus sclerosis, which included hippocampal atrophy and loss of head, digitations and signal alteration were seen in most of the patients. Another one is tumor and tumor-like condition. That's low-grade glioma. It's the most common and it's histopathically proven and full-of-piece of low-grade glioma. It's seen in this picture in the right high frontal temporal region as the post-operative and post-radio-carapace status. They may evade altered signal intensity in right frontal temporal region with the adjacent extension and interval appearance of a small enhancing region in right insular context with the surrounding areas of altered signal intensity which is showing increased perfusion on perfusion scan. The described findings were suggestive of the recurrence. The above one is low-grade. Now we'll see the high-grade glioma. This is a known case of glioplastoma multiformin. It's the pathologically proven case. The study revealed presence of a large, solid cystic lesion in a left parietotemporal and occipital lobe with the moderate perilligional edema. The lesion is compressing the left natural ventricle with the dilatation of right lateral ventricle and significant midline chip towards right side. Oligodendroglioma. This is a post-operative case of anaplastic oligodendroglioma. Post-operative cystic encephalomalletic changes are seen in right frontal cortical-sub cortical locations with significant perifocal white matter, long PR hyperintensity showing atrogynous post-contrast enhancement. Meningioma. This is a post-operative case of right parietal meningioma. The study revealed presence of a well-defined, extra-exhaustic postionist-enhancing mass region with a dural tail along the greater wing of spinoid bone on the right side. Tuberous sclerosis. The study revealed the presence of cortical tuberous ependymal nodules along the right tral ependymal surface of both lateral ventricles left, more than right and the white matter radial migration lines. The conclusion is MR imaging is a superior neuroimaging modality with no radiation exposure and should be the first investigation of choice in epileptic syndrome, cerebrovascular disease with a seizure, developmental cortical alfomaceous and vascular alfomaceous. Within identifying certain legions, location, extent of the legions, an amount of findings are excellent but has moderate sensitivity in patients with the generalized stonic-clonic seizures. It was observed that MR positivity was more in motor seizures, absence of seizures and motor seizures that most commonly affected the generalized stonic-clonic seizures cases. Our study observed that MRI was with appropriate imaging protocols at sensitivity and specificity in evaluation of symptoms. Thank you very much.