s / Brain Stimulation 8 (2015) 310e325 314 advances in PD therapy. Major symptoms can be explained by the overactivity of the inhibitory gamma aminobutyric acidergic output from the globus pallidum internum GPi. streotactic functional neurosurgery (SFN) can alleviate clinical symptoms as tremor, dyskinesias,painful dystonias or akinesia .the subthalamic nucleus (STN),the ventralis intermedium nucleus (VIM),and the GPi are the targets of this surgery. Material and Methods: Since july 2004,thirty-seven patients suffering from PDwere operated on in our department. .There were 26 men and 13 women ranging in age from 33 and 67 years: (lesionotomy of the GPi in 2 cases, of theVIM in 17cases) and bilateral deep brain stimulation (DBS) in 20 patients.The location thermolesion stereotactic electrodes and DBS were based on data fusion between CT image and cerebral magnetic resonance imaging for thermolesion but also on the intraoperative electrophysiological recording and in the case macrostimulation deep brain stimulation. The target, the burr hole and trajectory were defined by the fuser image to avoid vascular structures and ventricles. The MRI T1 and T2 sequences helped to visualize the STN. The accuracy of these location was obtained with macrostimulation in cases of thalamotomy or pallidotomy and with preoperative microrecordings in case of DBS. Results: Parkinson’s disease surgery both ablative and stimulation, is a to reasonable option for medically intractable patients that yield a good outcome provided good patient selection. As to lesionotomy, we are convinced that it is an excellent surgical alternative for management of patients in developing countries.