10year child on AZT+3TC+EFV since 4 weeks initially completed Intensive Phase of Pulmonary tuberculosis treatment and now on RH continuation phase.CD4 count 25cells/microlit.One week ago developed IRIS in the form of Lt side weakness and convulsions with unconciousness for 48hrs was treated with IV steriods and anticonvulsants and patient recover fully discharge on 7th day with continuation of both therapy anti tb and ART.As country do not have facility of CT scan or other lab back up to substantiate clinical diagnosis.Now child is having irritability and abnormal behaviour;restlessness.