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To the Editor:With interest,we read the article by Yu et al.[1] about the clinical presentation and central nervous system (CNS) imaging in 19 patients with Kes-Sayre syndrome (KSS),of whom 12 were genetically confirmed.We have the following comments and concs.The main disadvantage of the study was that the diagnosis was not genetically confirmed in all patients and mitochondrial DNA (mtDNA) deletion was detected in only 63％ patients,[1] What was the reason for seven KSS patients not undergoing genetic testing?Did not all patients undergo muscle biopsy?