Brain surgery may be a good treatment for patients where the medication does not have anymore the desired effect of supressing the symptoms. Such a surgery belongs to the "advanced treatments" group that can be considered in this situation. By far, not all people with parkinsonism are eligible for a brain surgery. Several factors such as age, the response to the medication, and the cognitive abilities play a role in determining whether or not someone can be operated. The other advanced treatments are the 'apomorphine pump' and a 'levodopa gel pump'. Please discuss these options early on with your neurologist!