Mira had another episode at school yesterday, where she was having multiple tonic-clonics within a short period of time, which prompted the her teacher and the school nurse to call us at home. We decided to pick her up again from school and take her back home, again contemplating whether or not we should administer Diastat. This is the second time in the last three weeks where we have had to pull her from school because of her seizures - this also marks the fourth or fifth of these episodes she has had in the last three months, which is a significant increase since this summer alone. Prior to this year, she has maybe had 2 or 3 in the last 8 or 9 years - the fact that she has had 5 in the last 4 months is disconcerting to say the least. We are pretty baffled as to why she is having so many of these episodes. We decreased her pyridoxine dosage well below a therapeutic range and we haven't made any other medication or dietary changes for nearly a year. Her weight has been steady over the past year or so as well, which probably rules out any potential need for an increase in her current medications. She is still taking Lyrica and Vimpat.
During her episode at school, Mira either bit her tongue during one of the seizures or she has lost another tooth. Her teacher notified us immediately that she saw some blood in her mouth right after the seizure, which leads me to believe she bit her tongue during one of them. We couldn't get her to drink anything until late in the day, as she continued to be postictal for hours after all of the seizures. We couldn't feel anything on her tongue, but she is missing one of her upper left teeth. She finally started to drink something and ended up discharging a lot of dried blood that was in her mouth, but we still couldn't figure out where it was coming from.
Yesterday was an exhausting day for her. This morning she seems to be feeling much better.