A challenge in treating epilepsy is the accurate documentation of seizure frequency, which is needed in order to assess the benefits of ongoing treatment. We present a 17‐year‐old girl who underwent video‐based monitoring in order to establish an accurate seizure count before and after the implantation of a vagus nerve stimulator to treat refractory epilepsy. The results show a reduction in disabling seizure types after vagus nerve stimulator implantation and highlight the inconsistencies between the reported and actual seizure count in this patient. Our case adds to the recognised issue of inaccurate seizure documentation. [Published with video sequence on http://www.epilepticdisorders.com]