I read the article by Hirayama et al1 on reverse Shapiro's syndrome in a 14-year-old girl with agenesis of the corpus callosum with interest. I wish to add six additional studies of cases of Shapiro's syndrome, three ante mortem2-4 and three post mortem5,6 that were not cited by the authors. In addition, the authors fail to mention that sympathectomy has also been proposed as a possible treatment.7