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Objective: To gain insight into patient awareness of symptoms associated with a TIA or stroke and the speed at which medical help is sought., Design: Observational study., Methods: The study was conducted with patients admitted to our Stroke Care Unit after having experienced a TIA or stroke. A questionnaire was used to collect information on external factors such as the initial reaction of the patient, the presence of a bystander and knowledge about stroke. This questionnaire consisted of 18 closed questions and 2 open questions., Results: We included 105 patients who had experienced a TIA or an ischemic or haemorrhagic stroke. Mean age was 71.6 years. Overall, 54% of these patients had undertaken no action within an hour of their first symptoms. The main reasons for this were a lack of insight into the symptoms associated with stroke or the expectation that the symptoms would disappear (73%). It appeared that 35% of these patients were not able to name one or more symptoms associated with a stroke., Conclusion: Patient knowledge of stroke and the awareness of the importance of urgent medical help are insufficient. These are important factors causing delay in rapid treatment with thrombolytics. National research is needed to explore whether our results are comparable to those in other regions of the Netherlands.

Introduction: McArdle disease is a hereditary myopathy caused by muscle phosphorylase deficiency. Patients experience painful muscle cramps after strenuous exercise; the condition is sometimes associated with rhabdomyolysis, myoglobinuria and resulting acute renal failure., Case Description: A 12-year-old boy visited the Paediatric and Neurology outpatients' departments with symptoms of leg myalgia, occurring during the warming-up phase of soccer practice, which disappeared after a short rest. Detailed history-taking revealed that he already experienced pain while walking during early childhood. An elevated serum creatine kinase concentration in combination with the typical presentation led to the presumptive diagnosis 'McArdle disease', which was confirmed by molecular genetic analysis., Conclusion: There is no effective gene therapy; a multidisciplinary approach by a neurologist, paediatrician, physiotherapist and nutritionist is advised.