Measuring neuro-haemodynamic correlates in the brain of epilepsy patients using 
EEG-fMRI has opened new avenues in clinical neuroscience, as these are two 
complementary methods for understanding brain function. In this study, we 
investigated three patients with drug-resistant reflex epilepsy using EEG-fMRI. 
Different types of reflex epilepsy such as eating, startle myoclonus, and hot 
water epilepsy were included in the study. The analysis of EEG-fMRI data was 
based on the visual identiﬁcation of interictal epileptiform discharges on scalp 
EEG. The convolution of onset time and duration of these epilepsy spikes was 
estimated, and using these condition-specific effects in a general linear model 
approach, we evaluated activation of fMRI. Patients with startle myoclonus 
epilepsy experienced epilepsy in response to sudden sound or touch, in 
association with increased delta and theta activity with a spike-and-slow-wave 
pattern of interictal epileptiform discharges on EEG and fronto-parietal network 
activation pattern on SPECT and EEG-fMRI. Eating epilepsy was triggered by sight 
or smell of food and fronto-temporal discharges were noted on video-EEG (VEEG). 
Similarly, fronto-temporo-parietal involvement was noted on SPECT and EEG-fMRI. 
Hot water epilepsy was triggered by contact with hot water either in the bath or 
by hand immersion, and VEEG showed fronto-parietal involvement. SPECT and EEG 
fMRI revealed a similar fronto-parietal-occipital involvement. From these 
results, we conclude that continuous EEG recording can improve the modelling of 
BOLD changes related to interictal epileptic activity and this can thus be used 
to understand the neuro-haemodynamic substrates involved in reflex epilepsy.