Medical treatment is very effective in controlling most symptoms of Parkinson’s disease. Most patients can carry out their daily activities on regular medications for 5 to 10 year with the help of proper medical management. A stage is reached when drugs alone cannot give adequate relief and patients’ day is interfered by repeated and sudden “off” periods. Some patients develop flowing body movements after taking medications -called dyskinesia. “Off” periods and dyskinesia are two phases of advanced Parkinson’s disease where drugs may be less effective and surgical options have an important role to play.