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Dear Marty, thanks for your E-mail. I just returned from a trip to South Africa, so that's why I am somewhat late in responding. > My question is - is it unreasonable for > me to think that I should not be having any severe off times> You are right, you should not have severe off times with bilateral STN stimulation. The following problems should be looked into: 1. Is the stimulation working i.e. are the stimulators switched on? 2. Was there a recent parameter adjustment? 3. Have you ever had prolonged periods without severe off times? 4. What are the stimulation parameters at this moment. Were they ever changed? 5. Were the electrodes placed in the STN? Please let me know the info you have on your stimulation parameters. Advice: Have yourself admitted to the hospital and have the doctor with the most expertise in STN adjust your stim. parameters and if necessary medication (remember the best results are achieved with a combination of stimulation AND medication!!). Best regards, Chris van der Linden, M.D.