 Hello everyone, I am Dr. Pratik Shah Satchani and the topic for my paper presentation is Imra Evaluation of Seizure in Pediatric Age Group Patients in the Rural Hospital of Central India. Introduction. A seizure is defined as abnormal electrical activity characterized by repetitive, irregular and synchronous neuronal activities. Epilepsy is a chronic condition characterized by repetitive and provoked seizures. However, in developing countries like India, studies have linked CNS infections to the most common cause of seizures in pediatric age group. With regards to investigative modalities, available for evaluation of seizures, EEG and Neurosynogram tend to be the initial investigations in neonates as they are non-invasive and non-ionizing. Imra is the modality of choice for evaluation of seizures and pediatric epilepsy as the neuroanatomy can be depicted in explicit detail with excellent gray white matter delineation. Aim of our study is to assess the role of MRI in identification of various etiologies and to study the spectrum of imaging appearances of different etiologies on MRI. Objective of our study are to identify potential cause for seizure in pediatric age group using MRI, to study association of HIE with perinatal insult and preterm birth, to study various imaging patterns associated with HIE, to study association of congenital malformation with preterm birth. Material and method. The study is performed in radio diagnosis department of AVBRH hospital, DMIHGR, VARTA. The research design is prospective cross sectional observational study with subjects of 138 pediatric patients. Materials and methods, sampling procedure. All the patients referred to the radio diagnosis department of AVBRH hospital, DMIHGR with seizures and the sample size came out to be 138 patients. Results, majority of the patients were male that is 70% and 30% for female. With respect to age distribution, majority of patients were in the age group of 0 to 3 years which were 48% followed by 4 to 6 years which were 21%. The majority of the patients presented with GTCS type of seizure which was 75% while 25% presented with partial seizures. Out of 138 patients, majority of them were preterm which was 72% and 28% were preterm. With respect to the distribution obtained based on the MRI finding, out of the 138 patients, abnormal findings were obtained in 62% and normal findings were obtained in 38%. Among the abnormal findings, the most cases were of HIE which was 27.9% followed by infection 25.5%, congenital malformation 25.5% and tumor 9.3%. In patients with HIE, a correlation was done between the presence of HIE with the history of perinatal insult and also with preterm birth. Out of 24 cases of HIE, 23 patients had the history of perinatal insult. Also, correlation was done for patients presenting with the findings of HIE and preterm birth. Out of 24 patients, 17 patients had history of preterm birth. In patients with HIE, imaging patterns were analyzed and three common imaging patterns were identified that is involvement of periventricular white matter, subcortical and periventricular white matter and involvement of bilateral basal ganglia, thalamus and cerebral lobes. Out of seven term patients with HIE involvement of bilateral basal ganglia, thalamus and cerebral lobes were seen in all seven cases. While in cases of preterm birth, 12 cases showed involvement of both periventricular and subcortical white matter, while five cases showed periventricular white matter involvement. Among patients with findings of infection, majority of them were of tuberculoma, 31.8%, viral encephalitis, six patients, meningitis, four patients, cerebral abscess, four patients and neurocystisercosis, one patient. Among eight patients of tumor, three were of pyelocytic astrocytoma, two of medioloblastoma and one case each of brain stem glioma, diffused febrile astrocytoma and this embryo-plastic neuroepithelial tumor. Among patients with findings of congenital malformations, majority of them had congenital aqueductal stenosis, eight patients, dandy wakum malformations, six patients, hypoplasia of corpus callosum, two patients, type 2, arnogeary malformation, two patients and rest of the cases for a focal cortical dysplasia, rhombo-encephalosynapsis, septo-optic dysplasia and open lip size and cafale constituting one case each. In patients with congenital malformations, associations were seen between findings of congenital malformation and preterm birth with history of preterm in 15 patients. Discussion. We did the study on 138 pediatric patients presenting to the department of radiodiagnosis with clinical presentation of seizures. Distribution based on gender. In our study, majority of the patients were male which were in accordance with study done by Mian Tambe et al. Distribution based on age. In our study, majority of the patients were of age group 0 to 3 years followed by patients of age group 4 to 6 years which was in accordance to the study done by Mian Tambe et al. Distribution based on type of seizures. Majority of our patients were of GTCS followed by partial seizures which was in accordance to the study done by Umap et al. Distribution based on presence or absence of abnormal MRI findings. In our study, 62 patients of the patient had abnormal findings which was in accordance with the study done by Anand et al. Distribution based on time of delivery. In our study, majority of the patients had term delivery 72% while only 28% had preterm delivery which was in accordance to the study done by Mathur M et al. Distribution based on etiology of abnormal MRI findings. In our study, majority of the patients with abnormal MRI findings were found to be of HIE 27.9% followed by congenital malformation and infection which was in accordance with study done by Umap et al. Sahadev R et al. and Mathur M et al. Association of HIE with prenatal, perinatal insult. In our study, we found that majority of the patients with findings of HIE had on MRI had history of perinatal insult which was in compliance with the study done by Mathur M et al. Conclusion. MRI plays a significant role in patients of pediatric seizures with identification and delineation of severity of wide variety of etiologies thus helping in further management and treatment of patients. Also, it allows for much better identification and characterization of focal brain lesion. The added advantage is that it's non-invasive, non-ionizing which is especially important in pediatric age group cases. This is a case of a pediatric patient with pulmonary TB who presented for MRI brain. This is the axial section post contrast image showing ring enhancing lesions in right frontal parietal region which was suggestive of tuberculoma. This is a case of HIE in preterm child showing hyper intensities in T2 flare periventricular region with no restriction on DWI. These are my references. Thank you.