X linked Dystonia Parkinsonism (XDP) is a progressive movement disorder among male
inhabitants of the island of Panay in the Philippinesi, it would start as a focal dystonia then
become generalised. The disease is believed to be due to a founder mutation of some 50
meiotic generations ago;;_ Although initially seen in male population, current data shows
otherwise. Reports of about 11 female cases are detected and listed in the registry. Male more
than female predilection is seen with a ratio of 75:1 iii_ XDP is a very disabling degenerative
disease causing involuntary torsion of the body, torticolis, blepharospasm and eventually
parkinsonian featuresiv. There is no known treatment, and alleviation of symptoms is difficult to
achieve, some patients even die due to infection and self harm. This report will present a case
of XDP with predominating parkinsonian feature, who has undergone bilateral Globus Pallidus
lnterna(GPi} Deep brain Stimulation (DBS}. After the operation, return to functionality and
improvements in activities in daily living is seen. The UPDRS and FMDRS scores show
improvement noted on regular follow up. However adverse effects such as slurring of speech
and minimal blepharospasm are still observed.