Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 4 2023 10 08 407 410 EN Azim Honarmand Department of Anesthesiology, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. Alireza Hoghooghy Department of Anesthesiology, Isfahan University of Medical Sciences, Isfahan, Iran. Amir Mahabadi Department of Neurosurgery, Isfahan University of Medical Sciences, Isfahan, Iran. Mohammad Reza Safavi Department of Anesthesiology, Isfahan University of Medical Sciences, Isfahan, Iran. Behzad Nazemroaya Department of Anesthesiology, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. 2023 07 22 2023 08 12 In the present manuscript, an 87-year-old man, who was a candidate for knee joint replacement surgery due to severe osteoarthritis of the right knee, was case reported. He underwent neuroaxial anesthesia. Following spinal anesthesia with bupivacaine 0.5% in the fourth and fifth lumbar vertebra, the patient developed myoclonic seizures in the lower limbs and abdomen that lasted during the surgery, as well. Due to the continuation of the seizures, the necessary examinations were performed and an extra-axial tumor in the left parasagittal was detected in the patient’s brain imaging. https://aacc.tums.ac.ir/index.php/aacc/article/view/816