 I am Dr. Namrata Zumale, junior resident in the department of radio diagnosis, hemorrhage and medical college and hospital level. My topic for presentation is hemiconvulgen hemiplesia under the guidance of Dr. Gayathri Patil, associate professor and head of department, department of radio diagnosis, hemiconvulgen hemiplesia epilepsy syndrome is a rare enical syndrome of any child who is associated with cerebral hemiatrophy and transient of permanent epilepsy as sequelae to the plurulom status of epilepsy which was first triggered by French neurologists and real start. It is characterized by appearance of plurulom plurulomic epileptic disorders affecting one side of the body in the course of a febrile disease in children under 8 years. Three stages of HHS syndrome include plurulom focal ceaseless development of hemiplegia of varying intensity. Development of epilepsy, plurulonset ceaseless without impairment of consciousness. There is characteristic holochemispheric global atrophy on her lateral to the hemiplegia not restricted to any vascular territory. HHS syndrome has been linked with the plurulom febrile ceaseless however a mechanism exact mechanism is still. Several factors for pathogenesis have been proposed which include plurulom febrile ceaseless with an activation of cell injury, predisposing genetic factors on vocal epileptogenic regions, inflammatory changes and plurulom ceaseless causing impairment of the blood brain barrier for the epilepsy. Plurulom ceaseless of long duration, impairing metabolism of neurological cells leading to the excitotoxic signage. Ames and obstetrics of this study the utility of MRI as a method of imaging to diagnose patients with HHS syndrome in actual as well as chronic stages. Obstetive is to study the characteristic of HHS syndrome and its features on MRI and to differentiate this disorder from similar appearing spectrum of disorder such as incursives. Materials and methods are as this is a descriptive case studies done in tertiary care center with 35 MRI studies in pediatric age group over the period of three months for patients with HHS syndrome were identified, patients age range from 10 days to 12 years, all patients were scanned on Toshiba 1.5 ASMR machine and HHS syndrome was diagnosed with characteristic MRIs. First case a four-year-old male child presented to the emergency with uncontrolled seizures and loss of consciousness. He developed a high grade fever with vomiting five days back which was followed with abnormal body movements involving left upper and lower limbs and loss of consciousness. The child had no former significant history rest the child had developed normal and all the age-appropriate program development milestones were achieved. MRI of this giant little bit very good but if you cerebral edema involving the right cerebral hemisphere it also shows T1 ISO and T2 flare hypersignal intensities into the right cerebral hemisphere. There is mild mass effect in the form of compression of right lateral ventricle and media midline shift to the left side. This T2 flare hypersignal intense area shows restriction of diffusion on ADC and DWI images. There is subtle electromagnetic enhancement involving the along the right cerebral hemisphere. These MRI features were proposed as a acute phase of HHS syndrome. Differential diagnosis even was an acute phase of process of internalitis. Second case was a three-year-old male child presenting to the emergency with components of high grade fever and vomiting since four days followed with uncontrolled prolonged hemorrhagic symptoms involving left upper and lower limbs. There was no significant prior history patient was apparently outright till the onset of two years. The MRI picture of this child revealed a few cerebral edema involving the right cerebral hemisphere. There was subtle flare hypersignal intensities involving right cerebral hemisphere which showed diffusion restriction and drop on ADC mapping on right-sided cerebral hemisphere. These MRI findings were with a mild mass effect and midline shift to the left were diagnosed as acute phase of HHS syndrome. Differential diagnosis even was acute phase of process of internalitis. Third case was two-month-old female child presented with right-sided weakness since one month. The child had normal vaginal delivery. However, febrile episode in postnatal fever followed with status epilepticus resulted in NICU stay for one week. No prior history of prenatal insert birth trauma was given by parents. MRI revealed diffuse cerebral entropy involving left cerebral hemispheres with changes of gliosis. There was lavender necrosis involved with the left parietal occipital region. Incidentally, there was E2L. Area of blooming noted in the left ventricle occipital fund suggestive of intraventricular hemorrhage. The case was diagnosed as chronic phase of HHS syndrome. Differential given was chronic phase of process of internalitis. Another case, a two-year-old male child presenting to the emergency with right-sided weakness and chronic movements the right hand and legs since four months had a previous history five months back when he had an episode of high blood pressure which was followed by prolonged uncontrolled abnormal body movements involving the right side. The child had been treated for the status epilepticus. Otherwise, previous history of this child was normal. Even antituated images in this child showed diffuse cerebral atrophy involving the left cerebral hemispheres with areas of gliosis and significant dilatation of left lateral ventricle. There was D2L hypersignal intensities in the cortical regions of the atrophied left cerebral hemispheres. Incidentally, there was cerebral hemispheres atrophy of the left cerebral peduncle was also noted. The children with HHS syndrome usually have less than four years of age with history of concurrent febrile illness. This syndrome can be idiopathic which has acuton set of fever and extracranial infusion or symptomatic onset which is associated with fever with some primary insert. In the case of HHS immature cerebral tissue of child develops unilateral ethyl discharges which is resulting in the excessive neuronal activity via NMDA receptor that causes increased calcium levels resulting in cytotoxic arena and then necrosis. Silent features include prolonged uveilateral seizures which may associated with autonomic symptoms, acute phase of epilepsy will result in the cerebral edema. The MRI shows cerebral edema of the cortical white matter and prominent diffusion restriction with affected cerebral hemispheres doing diffuse cerebral edema. In late stages edema will be followed by characteristic diffuse cerebral hemispheres and gliosis. Geography is usually normal but might show the narrowing of the cannibal of the cells. Close differential diagnosis is Rasmussen's encephalitis which includes inflammatory neurodegenerative disease of unknown etiology that causes severe chronic unihemispheric disease or cirrhosis which is usually seen in children with less than 10 years of age and causes progressive cognitive decline, neurological deterioration and intracranial seizures of the penis. Treatment include mainly in early acute phases supportive treatment in short term most children once the initial streusebilectomy is involved. Most effective way to prevent post-conversive hemiplegia is early and aggressive combination of symptoms. For new non-respondent patients surgical intervention can be advised. Differential diagnosis to be considered for cerebral hemipropia includes HHG syndrome, Rasmussen's encephalitis, Stoge Weber's syndrome, infections or inflammatory changes like unihemispheric, cerebral vasculitis, cerebral infarctions, hypoxic ischemic disease, hemimegal encephalitis and hemiprofit with developmental venous arteries, post-conversions. These are my demographic and clinical results. In conclusion, HHG is a rare clinical syndrome of infancy or early childhood associated with cerebral hemiatrophy and panacea for per minute. Let's see as sequelae to the prologue status. MRI adds in early recognition and initiation initiating seizure control which is of utmost importance to prevent the development of hemiplegia and intractable illness. These are my references. Thank you.