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Kazumi Hirayama, MD
Department of Neurology Fukushima Medical College Hikarigaoka 1 Fukushima 960-12, Japan

Yosihiko Hoshino, MD; Hisashi Kumashiro, MD; Teiji Yamamoto, MD
Fukushima, Japan

Arch Neurol. 1995;52(6):547.

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In reply

We thank Jeret for pointing out other cases of Shapiro's syndrome and for describing another proposed form of treatment (total sympathectomy) for this syndrome.

In our article,¹ we did cite the study by Noel et al² that described their findings at autopsy. Postmortem pathologic findings were documented in the article by Pineda et al³; however, the examination revealed diffuse severe spongiosis of the white matter and some of the subcortical nuclei. This made it difficult to determine the lesion responsible for the hypothermia. There were three other cases^4-6 that were similar to the 15 cases cited by us.

Carr-Locke and Millac⁷ proposed total sympathectomy as a possible form of treatment. Fox et al⁸ treated their patient, who had spontaneous periodic hypothermia, without agenesis of the corpus callosum, using this form of treatment. However, the majority of patients with Shapiro's syndrome^5-7,9-12 showed . . . [Full Text PDF of this Article]

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