We present the case of a 70-year-old female with no prior neurological disorders underwent a right total hip arthroplasty under spinal anesthesia. Patient tolerated the procedure well; however, a few hours postoperatively, she developed repetitive, jerky movements involving both upper and lower extremities (more prominent on the left side), along with altered mental status, staring spells, screaming, and episodes of visual hallucinations. Concerning potential hypoxic brain insult, underwent CT head, CTA head and neck, MRI brain, and a 24-hour EEG, all of which were unremarkable. She was treated with lorazepam and clonazepam, after which the movements slowed, and her neurological symptoms resolved completely over six weeks.

A year later, following another surgery, she again developed nonverbal behavior, myoclonus in the left arm, and bradykinesia in the right arm in the recovery room. CT head and EEG were again unremarkable, and symptoms resolved spontaneously within hours. 

A detailed review of her medications revealed that propofol (10mg/ml) had been administered in both surgeries for approximately two hours, indicating post-anesthetic SLP as the probable etiology for her recurrent neurological symptoms.