Deep Brain Stimulation of the Subthalamic and Pedunculopontine Nucleus in a Patient with Parkinson's Disease

bility.The patient underwent DBS of the PPN and STN in our institute. CASE REPORTA 61-year-old male with complaints of falling, gait instability and difficulty walking was admitted to the neurology ward.He started having mild difficulty walking and using small steps to walk 2 years ago, and his symptoms have gradually deteriorated.Three months before admission, sudden freezing during gait and turns led him to fall frequently.He also experienced rigidity and a mild tremor.The neurological examination revealed bradykinesia, rigidity, postural instability, and a mild resting tremor.His expression and speech were lowered.He also had mild hypophonia.He hesitated when initiating walking.A few steps later, he would suddenly freeze and fall forward.He could not make a turn without assistance.His muscular tone was enhanced, and the Babinski sign was absent.A cranial MRI revealed mild atrophy, which was slightly more prominent in the cerebral peduncle.The administration of both levodopa and dopamine agonists improved his appendicular motor symp-•