Neurology · Comprehensive Seizure Record

Phoebe · Seizure Tracking Summary

Days 1–10 (04–13 Jun 2026) · FCD type IIb confirmed; now home on Vigabatrin + Lacosamide with Phenytoin taper

Diagnosis

Focal cortical dysplasia (IIb)

Status

At home from 12 Jun

Patient

Phoebe

Date of birth

28 Oct 2018 (7y)

Weight

22.8 kg

Recording period

04–13 Jun 2026

Prepared by

◆ Diagnosis confirmed · 11 June

The second MRI (ketamine-assisted, 11 Jun 12:00) confirmed Focal Cortical Dysplasia (FCD) type IIb, with results delivered that night. This is a structural, focal malformation of the cortex and a recognised cause of focal epilepsy, consistent with the frontal-lobe focus seen on EEG and with Phoebe's drug-resistant seizure pattern.

EEG

Seizure activity localised to a frontal lobe region; typical event captured

Medications

Vigabatrin + Lacosamide ongoing; Phenytoin tapering to stop 21 Jun

Status

Came home 12 Jun 16:00; warning aura now felt before some seizures

133

Events, Days 1–10

74%

Awake / resting

25%

Sleep-related

43%

At the medication trough

3

Medications in play

Circadian pattern · every recorded event (Days 1–10)

Awake / resting Sleep-related Preceded by aura Shaded = medication trough windows

Each marker is one timestamped event. Phoebe came home on Day 9 at 16:00 (marked); events before then were in hospital. Shaded bands are the pre-dose periods when medication cover is weakest.

Key events timeline & day ranking

Tue 3 Jun16:00 · pre-admission

Investigation

First MRI

Result inconclusive; a repeat scan was planned.

Wed 4 JunDay 1

Admission

Admitted to hospital

Seizures tracked from this day; Levetiracetam started (first dose 15:00).

Wed 4 JunDay 1

Investigation

EEG monitoring

Video-EEG captured a typical event; localised to a frontal lobe region.

Sun 8 JunDay 5

Medication

Lacosamide started

145 mg IV loading dose.

Mon 9 JunDay 6

Medication

Phenytoin introduced

Added as a further medication (16:00).

Tue 10 JunDay 7

Medication

Levetiracetam stopped

Withdrawn after a taper.

Wed 11 Jun12:00 · Day 8

Investigation

Second MRI

Ketamine-assisted MRI performed.

Wed 11 Jun19:04 · Day 8

Medication

Perampanel started

Single 2 mg dose.

Wed 11 Junthat night · Day 8

Diagnosis

Diagnosis: FCD type IIb confirmed

MRI confirmed focal cortical dysplasia type IIb; results delivered that night.

Thu 12 JunDay 9

Medication

Perampanel stopped

Discontinued after the single dose; switched to Vigabatrin.

Thu 12 Jun09:25 · Day 9

Medication

Vigabatrin started

New anti-seizure medication added.

Thu 12 Jun16:00 · Day 9

Home

Came home

Discharged from hospital.

Day ranking

Calmest to hardest, by number of seizures

1Day 25 Jun10calmest

2Day 36 Jun11

3Day 58 Jun13

4Day 14 Jun14

5Day 47 Jun15

6Day 710 Jun15

7Day 811 Jun15

8Day 69 Jun17

9Day 912 Jun19hardest

·Day 1013 Jun4partial

Ranking covers complete days (1–9). Day 10 is a partial day so far and is shown separately, not ranked.

High-level chronology of Phoebe's admission, from the first MRI and first tracked seizures through investigations, medication changes, the confirmed diagnosis, and coming home. Dose-by-dose detail is in the medication journey; every seizure is in the full event log.

Seizure timing vs medication coverage

43%

Across all 10 days, 43% of seizures (57 of 133) fall in the final third of the dosing cycle — when medication has worn down to its weakest, just before the next dose. Only 30% happen in the first third just after a dose. The single biggest slice is the 10–12 hour pre-dose window at 26%. Seizures keep breaking through as the drug wears off.

Seizures by time since last dose

Based on the twice-daily schedule that applied through most of the record (mornings ~09:00, evenings ~21:00).

Coverage at a glance

43%

in the weakest-cover third (8–12h post-dose)

30%

in the strongest-cover third (0–4h post-dose)

Doses have now moved earlier (Phenytoin 07:00/19:00; Vigabatrin + Lacosamide 08:00/20:00), so the trough windows shift roughly 1–2 hours earlier going forward. Worth watching whether the early cluster moves with the new timing.

The two trough windows · when cover is lowest

Pre-dose trough hours (06–09 & 18–21) Other hours

The two pre-dose windows cover 25% of the clock but hold 38% of seizures. Morning trough 06–09: 23% of events, on all 10 days. Evening trough 18–21: 15% of events, on 9 of 10 days.

Current medication schedule

Medication	Morning	Evening
Fenitoína · Phenytoin (tapering)	07:00 per taper below	19:00 per taper below
Vigabatrina · Vigabatrin	08:00 250 mg (½ tablet)	20:00 250 mg (½ tablet)
Lacosamida · Lacosamide	08:00 75 mg	20:00 100 mg (½ tablet)

Timing updated today: Phenytoin moved to 07:00 / 19:00 and the other medications to 08:00 / 20:00 (the printed prescription had Vigabatrin and Lacosamide at 09:00 / 21:00). Vigabatrin: 1 tablet = 500 mg, so 250 mg is half a tablet. Lacosamide: 1 tablet = 200 mg. Phenytoin syrup is 30 mg / 5 ml.

Phenytoin taper (desmame) to 21 June

Dates	Morning dose	Evening dose
11–12 Jun	60 mg (10 ml)	40 mg (6.6 ml)
13–14 Jun	40 mg (6.6 ml)	40 mg (6.6 ml)
15–16 Jun	40 mg (6.6 ml)	20 mg (3.3 ml)
17–18 Jun	20 mg (3.3 ml)	20 mg (3.3 ml)
19–20 Jun	—	20 mg (3.3 ml)
21 Jun	stop	stop

From the prescription. Phenytoin syrup 30 mg / 5 ml; doses now given at 07:00 and 19:00. Stops after 20 June.

Medication journey & key events

04 Jun 15:00	Levetiracetam 3.2 mL First dose
05 Jun 00:00	Levetiracetam 3.2 mL Second dose
05 Jun 11:00	Levetiracetam 5 mL Dose increased
05 Jun 23:04	Levetiracetam 5 mL Evening dose; seizure occurred when woken
06 Jun 10:25	Levetiracetam 5 mL Morning dose
06 Jun 21:21	Levetiracetam 5 mL Evening dose; seizure occurred when woken
08 Jun 09:20	Levetiracetam 5 mL Morning dose
08 Jun 18:33	Lacosamide 145 mg Loading dose started; infused over 30 minutes
08 Jun 19:03	Lacosamide 145 mg Loading dose completed
08 Jun 20:00	Vomiting Vomited after loading dose
08 Jun 21:23	Levetiracetam Taper dose Original medication as part of 36-hour taper
09 Jun 01:00	Phenytoin Dose 2 Second dose reported between Day 6 and Day 7
09 Jun 08:49	Lacosamide 75 mg First maintenance dose after plan correction
09 Jun 16:00	Side effect After phenytoin: dizzy, unstable, unusually loud
09 Jun 16:00	Phenytoin Started Third medication introduced; later identified as Fenitoina / Phenytoin

09 Jun 21:00	Levetiracetam Taper dose Woken for meds; short seizure occurred
09 Jun 21:40	Lacosamide IV dose Behavioural/euphoric event around this time
10 Jun 07:41	Levetiracetam 1.7 mL Taper dose
10 Jun 09:30	Lacosamide 75 mg Maintenance dose
10 Jun 09:32	Levetiracetam 1.7 mL Duplicate dose given in error
10 Jun 12:52	Observation Phoebe reported she was no longer dizzy
10 Jun 19:09	Levetiracetam Final taper dose Final dose before stopping
11 Jun 00:06	Phenytoin 60 mg Maintenance dose; schedule being phased earlier by ~1h per dose
11 Jun 09:40	Lacosamide 75 mg Maintenance dose
11 Jun 12:00	Ketamine-induced MRI Second MRI performed after 12:04 brief seizure
11 Jun 19:04	Perampanel (single dose, discontinued) Given once (2 mg); not continued - switched to Vigabatrin after MRI result
11 Jun 22:00	MRI result: FCD type IIb Results delivered that night; focal cortical dysplasia type IIb confirmed
12 Jun 09:25	Vigabatrin New anti-seizure medication started
12 Jun 16:00	Came home Discharged from hospital
12 Jun 20:49	Evening anti-seizure medications Evening meds given 2 min after 20:47 seizure

Full sequence of doses and key events across the admission. Levetiracetam was withdrawn by Day 7. The current picture is Vigabatrin + Lacosamide, with Phenytoin tapering. Perampanel was a single dose only and was discontinued.

New clinical developments

◆ Diagnosis confirmed · Focal Cortical Dysplasia (FCD) type IIb

The repeat MRI on 11 June at 12:00 (ketamine-assisted) identified the cause: focal cortical dysplasia type IIb, with results given to the family that night. FCD IIb is a focal malformation of the cortex and a well-recognised cause of focal, often drug-resistant epilepsy, which fits both the frontal-lobe EEG focus and the fact that seizures have continued through several medications. The implications for treatment, including whether epilepsy surgery is an option, are noted as priority questions for the team.

Warning aura identified (Day 7)

Phoebe has begun feeling seizures coming on: quietness and fan-like noise, then a spine tingle rising from her lower back before the laughter comes, once asking for hands on her head. Recorded on 3 events. A rising sensory aura with preserved awareness is clinically meaningful — it can help localise and classify her seizures, and gives her a few seconds of warning. On Day 8 she also began warning Dad as a seizure started.

Other signals

New medication. Vigabatrin added Day 9 alongside Lacosamide; Phenytoin now tapering; Levetiracetam stopped Day 7. (Perampanel was tried once on Day 8 and not continued.)
Right eye twitch. Now seen across Days 6–8 (became prominent Day 8); a consistent right-sided sign may carry localising value.
Awareness. Recorded as preserved in most daytime events (eating, talking, answering, stopping the giggling herself).
Came home. Discharged 12 Jun 16:00; the early-morning pattern continued at home on Day 10.

Median event duration by day

Events were briefest around Days 7–8 (~15 sec); Day 9 saw a mix of short sleep events and stronger daytime laughing (up to 35–40 sec).

Side effects & events to discuss with the team

Vomiting after the Lacosamide load; dizziness/unsteadiness/loudness after Phenytoin (resolved Day 7 12:52); a behavioural/euphoric episode around the Day 6 21:40 IV dose; a duplicate Levetiracetam dose given in error (Day 7); and on Day 9 stronger laughing with knee weakness (15:35) and small urinary leaks.

Frequency & pattern over time

Events per day · awake vs sleep

Day 9 (first full day spanning discharge) was the highest at 19. Day 10 is partial (to ~08:30 today).

Awake vs sleep-related (overall)

98 awake / resting

33 sleep-related

2 self-reported

Across all 133 recorded events.

The picture so far

Frequency. Seizures continue daily; not yet controlled, with four medications now in play.
Timing. 43% hit at the medication trough; consistent clusters at 06–09 and 18–21.
Severity. Many events shorter/lighter than the first week, though Day 9 had some stronger daytime laughing.
New. A spine-tingle warning aura, a recurring right eye twitch, two new medications, and the move home.

Clinical observations

Diagnosis (FCD IIb). Confirmed 11 Jun: focal cortical dysplasia type IIb, a structural focal cortical malformation and recognised cause of drug-resistant focal epilepsy, consistent with the frontal-lobe EEG focus.
EEG. Doctors reported seizure activity localised to a frontal lobe region.
MRI. Second MRI (ketamine-assisted) on 11 Jun confirmed focal cortical dysplasia (FCD) type IIb; results delivered that night.
Two patterns. Daytime laughing/giggling with watery eyes/preserved awareness; sleep-related humming with occasional incoherent speech.
Sleep/wake vulnerability. Events repeatedly observed while falling asleep, waking, or being woken for medication.
Aura/spine tingle. Day 7: Phoebe described quietness/fan noise, spine tingle rising from lower spine, then noise/laughter coming out.
Right eye twitch. Observed Day 6 07:08, Day 7 16:25, Day 8 08:05.
Urinary leakage. Peaked Day 5; reduced Day 7/8, but returned in some evening Day 7 events.
Medication side effects. Dizziness/instability/loudness after phenytoin; dizziness resolved Day 7 12:52.
Response pattern. Seizures not stopped, but several became shorter/lighter after lacosamide/phenytoin; Day 8 had no observed overnight seizures.
Perampanel (discontinued). Given as a single 2 mg dose on Day 8; discontinued and not part of the ongoing regimen (switched to Vigabatrin after the MRI result).
Vigabatrin. Started Day 9 at 09:25; seizures continued but afternoon/evening intervals widened.
Day 9 severity. Mixed severity: some short sleep events, stronger laughing with small wee at 11:15, red-faced/knee weakness at 15:35, proper laughing + wee at 19:45.
Day 8 eye twitching. Recurring eye twitching became prominent on Day 8.
Day 10 overnight. Day 10 began with brief 2-second laughing event at 06:29 after a 9h42m observed gap.
Data caveat. Earlier Day 1-6 rows are reconstructed from chat/report; Day 8-10 include photo/bedside tracker corrections.

Observations as recorded by the family and care team. Presented for clinical interpretation; no diagnosis or treatment conclusion is implied beyond what clinicians have reported.

Before vs after Vigabatrin

Early

Vigabatrin was added on 12 June at 09:25 (Day 9). So far there is no clear change in seizure frequency — about 14.5/day before and 14.6/day after — but the post-Vigabatrin window is only about one day, far too short to judge, and Vigabatrin is usually titrated up over time. This section is a baseline to track from, not yet a verdict.

Seizures per day · before vs after

Rate, not raw counts, because the windows differ in length: 118 events over ~8.1 days before, 14 events over ~1.0 day after.

What we can say so far

Frequency. Essentially unchanged in the first day (14.5 vs 14.6 per day). Too early to read anything into this.
Duration. Median 21s before vs 25s after — broadly similar.
Pattern. Care team noted afternoon/evening intervals appeared to widen on Day 9; worth watching as the dose is built up.
To track. This page should be revisited after several days on a steady Vigabatrin dose for a fair before/after comparison.

Pre-Vigabatrin spans Day 1 to 12 Jun 09:25; post-Vigabatrin is everything after. Because the post window is so short and the dose is still being established, the comparison is a starting baseline only.

Seizure pattern · visualisation options to choose from

Four different ways to show the same data. Have a look and tell me which one (or more) you'd like to keep in the main report; I can drop the rest, resize, or combine.

Option A Daily seizure count with medication changes

The classic seizure-diary view: how many per day, with dashed lines marking each new medication. Easy to read trend and link it to treatment. (Day 10 is partial.)

Option C Day × hour heatmap

Each square is one hour of one day; darker = more seizures. Shows the daily load and the time-of-day clustering (mornings and evenings) together in one grid.

Option D 24-hour clock

A round-the-clock view of when seizures happen, pooled across all days. Each spoke is an hour; longer = more seizures. The coral spokes are the pre-dose trough windows (06–09 and 18–21), which clearly stand out as the busiest times.

Option E Seizure type mix by day

Each day's seizures split by character, from milder humming and giggling through to stronger laughing. Shows how the type of seizure shifts over time, not just how many.

Tell me your favourite(s) and I'll fold it into the main report and remove this options section.

Full event log · Days 1–10 (133 events)

Time	Phase / state	Dur.	Features	Notes
Day 1 · Fri 05 Jun
00:57	—		Typical	After transfer to new ward
06:00	—		Self-reported	Self-reported before first witnessed event
06:47	Awake	30s	Humming/talking	Conscious, talking, asked brother to hold hand
07:36	Awake		Typical	Playing ball / keepie-uppies
08:17	Awake		Laughing	In car; could raise arms and repeat phrases
09:27	Awake	20s	Typical	Hospital waiting room; could pick up doll but mislocated it
10:13	Awake		Laughing	Outside with Dad talking about tests
11:28	Awake	20s	Freeze/typical	Balancing on tree roots; froze briefly
12:13	Awake		Typical	During EEG; typical event captured
13:34	Awake		Typical	After wee and poo
14:38	Awake		Mainly humming, few giggles	Watching movie; no urinary leakage noted
19:15	Awake		Typical	Hospital bed; after first levetiracetam dose
21:35	Sleep		Typical	Falling asleep
23:25	Sleep		Humming only	Woke from sleep; reached for hand; speech incoherent
Day 2 · Fri 05 Jun
06:47	Awake		Laughing	Shorter; showing where mum was sleeping
08:36	Awake		Laughter + humming	Colouring with headphones
09:44	Awake	40s	Laughter + humming	Talking; vibrating sensation
11:09	Awake		Laughter + humming	Needed wee and got out of bed during seizure
12:45	Awake	25s	Laughing + humming	On Dad's lap; normal laughter transitioned into seizure laughter
14:39	Awake		Typical
16:34	Awake		Laughing	After jogging back to playroom
18:30	Awake		More humming than giggles	Eating dinner
20:39	Sleep		More humming than giggles	Lying down trying to sleep
23:04	Sleep		Humming	Woken for medication; speech hard to understand
Day 3 · Sat 06 Jun
07:03	Sleep	10s	Humming	Very short after waking
08:55	Awake		Mainly humming	Shorter, less aggressive
10:19	Awake		Laughing watery eyes	During blood pressure cuff
12:08	Awake	45s	Laughing + humming
13:29	Awake	45s	Laughing watery eyes
15:03	Awake	45s	Typical	Paused while looking into bag before seizure became obvious
17:14	Awake		Typical
18:39	Awake	30s	Laughing	Gentler; no watery eyes; normal laughter changed into seizure laughter
19:59	Awake		Giggling/laughter watery eyes	Getting into bed
21:21	Sleep		Humming	Woken for medication; eyes open; speech difficult; back to sleep
21:38	Sleep	10s	Humming	Sat up, sleep talking, eyes open; back to sleep
Day 4 · Sun 07 Jun
06:32	Sleep	10s	Humming	Woke from sleep; incoherent speech
07:15	Sleep	10s	Very short	Asleep, woke briefly, went back to sleep
07:50	Awake		Short
08:50	Awake		Humming + little giggle	Breakfast
10:20	Awake		Typical	After shower; intense itching beforehand
11:30	Awake	36s	Laughing watery eyes	Video captured
13:20	Awake		Giggles -> watery eyes -> humming watery eyes	Playing with new friend in playroom
14:35	Awake		Laughing	Continued eating cheese string
16:00	Awake	40s	Laughing leakage	Bed change
17:17	Awake	40s	Laughing
18:27	Awake	30s	Laughing	Answered time question quickly
19:43	Awake		Very brief/self-reported	Dad briefly out; almost forgot to mention it
21:01	Sleep		Giggling -> humming leakage	Lying in bed, not asleep
21:52	Sleep		Humming -> jibberish speech	Back to sleep
22:59	Sleep	10s	Humming	Very short, back to sleep
Day 5 · Mon 08 Jun
01:11	Sleep	10s	Humming	Very short
02:44	Sleep	10s	Humming	Eyes stayed closed
05:19	Sleep	10s	Humming	Quick humming
07:22	Awake	40s	Laughing watery eyes
09:14	Awake		Laughing	Stood up
10:45	Awake	38s	Laughing watery eyes	Watching tablet
12:24	Awake	45s	Laughing leakage	Playing tablet in activity room
13:48	Awake	40s	Laughing leakage	Face looked strained/pained but no pain
15:01	Awake	45s	Laughing leakage	Lying on bed getting massage
15:58	Awake	35s	Laughing leakage	Talking about party bags
17:13	Awake	40s	Laughing leakage
18:01	Awake		Laughing leakage	5-10 min after cannula distress while calming; weaker-legged afterwards
23:20	Post-Lac	10s	Humming	First recorded event after lacosamide loading dose
Day 6 · Tue 09 Jun
01:46	Post-Lac	10s	Humming + brief speech	In sleep
03:08	Post-Lac	10s	Humming	In sleep
03:16	Post-Lac	10s	Humming	In sleep
04:37	Post-Lac	15s	Humming + few giggles	Slightly longer
06:32	Post-Lac	15s	Humming + few giggles	Similar to 04:37
07:08	Post-Lac	45s	Giggling eye twitch	Sat up in bed; right eye twitch observed
08:59	Post-Lac	45s	Giggling leakage	Sitting on bed; shortly after lacosamide maintenance dose
10:15	Post-Lac	45s	Giggling leakage	After snack, sitting in bed
12:10	Post-Lac	45s	Giggling	On bed
13:30	Post-Lac	20s	Proper/real laughing
15:15	Post-Lac	20s	Proper laughing
16:00	Lac+Phen		During new medication process	Phenytoin introduced
17:24	Lac+Phen	10s	Very small, brief giggling
19:28	Lac+Phen	10s	Very small, brief giggling
20:09	Lac+Phen		Short giggles
21:00	Lac+Phen		Short	Woken for medication
21:40	Lac+Phen		Possible seizure / behavioural event	Woke incomprehensible, smiley/euphoric, drunk/high; lacosamide IV dose at this time
Day 7 · Wed 10 Jun
07:37	Lac+Phen		Aura / seizure aura	Quietness, fan noise, spine tingle, looked left, touching ear
08:12	Lac+Phen		Seizure	Details pending
08:59	Lac+Phen		Very mild / genuine laughter	Video; looked like genuine laughter
09:30	Lac+Phen		Typical gelastic / false laughter	Returned to fake/false laughing
10:09	Lac+Phen		Seizure with aura aura	Asked for hands on head; spine tingle travels up before noise comes out
13:10	Lac+Phen	8s	Genuine laughter / very mild aura	Almost missed; under 10 sec; spine tingle confirmed
14:02	Lac+Phen	15s	Proper giggle	Gentle/proper giggle
15:05	Lac+Phen	8s	Very light giggle	Less than 10 sec; slightly embarrassed afterwards
15:45	Lac+Phen	20s	Proper laughing	Commented on smell of toy; hard to distinguish from normal laughter
16:25	Lac+Phen		Gentle laughing + eye twitch eye twitch	Definitely seizure; she thought lighter; eye twitch observed
16:55	Lac+Phen		Very mild giggling leakage	Almost not noticed; small leak; said she tried to control the giggles
18:02	Lac+Phen		Mild seizure	In line with lighter Day 7 events
19:26	Lac+Phen		Weird/characteristic laughter	17 min after final levetiracetam dose; wife noted original pattern/duration
20:05	Lac+Phen		Weird/characteristic laughter leakage	After shower; urinary leak
20:38	Lac+Phen		Weird/characteristic laughter	Lying in bed trying to sleep
Day 8 · Thu 11 Jun
07:30	Lac+Phen	25s	Weird giggling	Woken up; first observed seizure after seizure-free night
08:05	Lac+Phen	15s	Weird giggle eye twitch	Right eye twitch
08:37	Lac+Phen	15s	Weird giggle	Same as previous
09:23	Lac+Phen	25s	Weird giggle	Same pattern as previous
10:10	Lac+Phen	20s	Seizure	Occurred 30 min after 09:40 lacosamide
11:36	Lac+Phen	30s	Humming then laughter / crescendo eye twitch	4-5 hums then laughter; eye twitching more prominent; less aggressive than earlier days
12:04	Lac+Phen		Short giggling fit	Brief giggling fit before ketamine-induced second MRI
14:32	Lac+Phen	25s	Mild crescendo	Said at the end she stopped the giggling herself
15:09	Lac+Phen	20s	Same Day 8 pattern eye twitch	Eye twitching; similar to other Day 8 events
16:11	Lac+Phen	20s	Warning then pause then giggling eye twitch	She warned Dad as it started; pause; then giggling; eye twitching
16:43	Lac+Phen		Short seizure	Short one again
17:21	Lac+Phen		Eye twitching seizure eye twitch	Dad not present; family friend observed; slightly longer than before but no benchmark for friend
18:11	Lac+Phen	23s	Proper laughing	Proper laughing; 20-25 sec
18:27	Lac+Phen	23s	Proper laughing	Proper laughing; 20-25 sec
19:31	Lac+Phen	23s	Proper laughing	Proper laughing; 20-25 sec; after first Perampanel dose
Day 9 · Fri 12 Jun · came home 16:00
03:40	Lac+Phen		Very quick hum	Very quick one, just hum
03:54	Lac+Phen		Hum + one giggle	Opened eyes
05:05	Lac+Phen		Hum/giggle sleep event	Same pattern; unsure if eyes opened
06:25	Lac+Phen		Hum/giggle sleep event	Same pattern
06:45	Lac+Phen		Hum then giggle	Opened eyes, back to sleep
07:40	Lac+Phen		Seizure	Details not recorded
08:05	Lac+Phen		Seizure	From bedside tracker
08:34	Lac+Phen		Seizure	From bedside tracker
09:30	+Vigabatrin		Seizure	After Vigabatrin started at 09:25
10:05	+Vigabatrin		Seizure	From bedside tracker
10:45	+Vigabatrin		Seizure	From bedside tracker
11:15	+Vigabatrin	38s	Long laughter / not controlled leakage	35-40 seconds; long laughter; small wee
12:04	+Vigabatrin		Seizure	Additional seizure later confirmed
12:55	+Vigabatrin	25s	Strong laughing	More aggressive, between best and worst phenotype
15:35	+Vigabatrin	30s	Full-on laughing	Red-faced; knees gave a little; had to sit on Dad's knee; bashful asking nurse to remove cannula
16:05	+Vigabatrin		Very mild	Excitement about leaving
18:35	+Vigabatrin		Seizure	Details pending
19:45	+Vigabatrin		Proper laughing leakage	Proper laughing; urinary leakage
20:47	+Vigabatrin	25s	Firm giggling	25 seconds; evening meds at 20:49
Day 10 · Sat 13 Jun
06:29	+Vigabatrin	20s	Brief laughing	Woke up briefly, then back to sleep
07:39:00	+Vigabatrin	20s	Brief laughing	seizure as she transitioned out of sleep
08:30:00	+Vigabatrin	10s	Brief laughing	Whilst watching dinner
13:55	+Vigabatrin	25s	More intense; reduced engagement leakage	More intense during; could not engage/talk during, unlike before when she could mechanically talk after the first ~5 seconds. Big wee (large leakage).

Rows shaded gold fall in a medication trough window (06–09 or 18–21). Days 1–6 are reconstructed from earlier records; Days 8–10 include photo and bedside-tracker corrections.

Home-recorded observational data, compiled 13 June 2026 for clinical review.
133 events through Day 10. Medication regimen changed repeatedly across the record; trough analysis uses the typical twice-daily schedule. Figures shown as recorded.