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Roberto D'Alessandro, MD
Neurological Institute University of Bologna Via U. Foscolo 7 40123 Bologna, Italy

Arch Neurol. 1992;49(4):346.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—During last year, I sent to three medical journals a short report of a case describing a woman whose first and isolated symptom of her myasthenia gravis (MG) was, for some weeks, intermittent and short-lasting difficulty in pronouncing the sound. I stressed that no previous reports on such a peculiar speech disturbance as the early symptom of MG have been previously published. I suggested that this speech disturbance was due to the greater strength needed by the tongue muscles to pronounce sounds in Italian. The manuscript was rejected by all journals. I think this is probably right since my observation was not interesting enough to be published in such prestigious journals. More interesting were referees' comments, as given verbatim below.

Journal 1.

—"To assist in the review, without violating confidentiality, I asked several clinicians (both speech pathologists and neurologists) about their experience with the first . . . [Full Text PDF of this Article]

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