Abstract
Three patients, aged 7-15 years, with Guillain-Barré syndrome presented with pain as the primary complaint. Two did not complain of weakness
and their progressive loss of function was incorrectly ascribed to the pain. One did
complain of weakness, in association with flu-like symptoms, but the significance
of the complaint was not appreciated. At diagnosis all three had profound, predominantly
proximal weakness.
We believe the delayed diagnosis relates to doctors' lack of opportunity to examine
patients with muscle weakness. We conducted a questionnaire survey of junior hospital
doctors asking them about their hands-on experience of testing muscle strength and
about their knowledge of the Medical Research Council (MRC) Scale of muscle strength.
Doctors who claimed most experience did not have a better knowledge of the MRC scale.
We recommend doctors-in-training should be given more opportunity to examine patients
with muscle weakness and should be made familiar with a clinical scale of muscle strength.
Key words
Polyradiculoneuropathy - Medical education
