In this article, we use a case to illustrate and discuss some practically important learning points about programming subthalamic nucleus deep brain stimulation for Parkinson’s disease patients and highlight clinically relevant issues resulting from anatomical and device-related anomalies. These include the phenomenon of a dominant subthalamic nucleus, clinical variability with delayed response to stimulation, equivalence of electrical charge when using short-pulse settings, and issues regarding conversion of settings between constant-current and constant-voltage devices that are increasingly common with the use of device components from multiple manufacturers.

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