Consider the following medical report that includes the patient's historical health records. Use it to predict the disease that the patient is high likely exposed to. 

 Medical Report: service:neurosurgery history of present illness: this 59 year old right handed man was initially found to have a left parasagittal frontoparietal glioma in . he had right leg weakness developing back in . by the time he was operated on he had recurrent focal seizures and was having severe right virtually no fine motor control at the ankle or foot. his right upper extremity was affected as well, but to a much lesser extent. he had moderate fine movement in the right hand. he underwent surgical excision and there was malignant alteration with increased cellularity and single cell necrosis and extensive multifocal tissue necrosis with large diffusely infiltrating histologic benign component typical of required reoperation. at that time he had radiation therapy carried out near his home at hospital in , . he did well again until when he was found to have a small recurrence in the posterior margin of the removal cavity. he underwent focal radiation at . the area of gadolinium enhancement on mr scan cleared and he did well until the summer of when he started having focal partial seizures involving the right hand. repeat mri scan showed recurrence of a gadolinium enhanced tumor again in the posterior margin of the removal cavity in the parietal region posteriorly. repeat spect scan with thallium was consistent with tumor recurrence. this was compared with a prior thallium scan in prior to his high energy beam radiation to that site. the overall recommendation of radiation therapy was to reoperate and remove this area rather than consider any further high energy beam radiation at this time. it was thought that the risks outweighed the benefits and that since the area was one which could be approached surgically without high risk to function, removal of as much active tumor as possible was the best course of treatment. past medical history: he has known esophageal reflux. he did not use tobacco or alcohol. he had l5-s1 lumbar fusion many years before in the for spondylolisthesis of l-5 on s-1. he had the prior left parietal craniotomies in and . allergies: no known drug allergies. medications: he was taking zantac each day and 200 mg of tegretol four times a day. he was started on 2 mg of decadron four times a day the day prior to admission. physical examination: vital signs were blood pressure of 142/81, pulse 65, height 5'", weight 210 pounds. head, ear, nose and throat exams were normal. neck was supple with no adenopathy, no thyromegaly and trachea midline. chest was clear to auscultation and percussion. cardiac exam showed regular rate and rhythm, normal s1, s2 with no murmurs. abdominal exam showed no organomegaly, no masses or tenderness and all bowel sounds to be present. extremities showed no joint deformities, no peripheral edema and full pulses throughout. neurologic exam showed that the patient had normal cognitive function. he had right upper extremity weakness and fairly severe fine movement deficit now in the right upper extremity which was worse than prior to the tumor recurrence. lower extremities showed minimal movement of the foot at the right ankle in dorsiflexion with no separate toe movement. gross strength in the right lower extremity was good. he walked with a limp favoring the right side. sensory exam showed hyperesthesia in the right ring and little fingers without splitting of the ring finger. this was leading to a question of whether he might have some ulnar nerve entrapment syndrome at the elbow. reflexes were hypoactive in the upper extremities, 3+/4 at the right knee, at the left knee. laboratory data: admission cbc, pro time, ptt and platelet count were all normal. his post op tegretol level was 5+ but by the day of discharge was 10+ on 1000 mg per day. hospital course: following admission the patient was immediately taken to the operating room where the left craniotomy was reopened utilizing the navigational assistance of the viewscope for excision of the tumor recurrence. results of pathology were pending at the time of this dictation. postoperatively the patient did extremely well. on the second day of his post-op course he had a syncopal episode while sitting up for half an hour and had a focal seizure involving the right side. he had transient increased right sided weakness which cleared within several hours. from that point on he had no further problems. tegretol dose was increased from 800 to 1000mg per day. he had very little headache. he had no drainage from the incision site. he was afebrile. his right upper extremity deficit remained approximately the same as it had been prior to surgery. he was kept on 4 mg of decadron four times per day for the first four days postoperatively and then started on a decadron taper on the day of discharge, lowing his dosage by 0.5 mg each day, so that on the day of discharge he was to receive 3.5 mg on a four times per day basis, the day following that 3.0 mg dose of decadron four times per day and then taper carried out through the next several weeks. he had a tegretol level post-op that was in the 5 range and his tegretol dose was increased to five 100 mg tablets per day. however, on the day of discharge repeat level was over 10 and he was instructed to cut back to four per day again. discharge diagnoses: 1. recurrent left parietal oligodendroglioma. 2. esophageal reflux by history. 3. epilepsy secondary to diagnosis #1. discharge status: approved disposition: discharged home with followup appointments to be arranged. , m.d. dictated by: medquist36 procedure: other operations on extraocular muscles and tendons other excision or destruction of lesion or tissue of brain diagnoses: malignant neoplasm of brain, unspecified epilepsy, unspecified, without mention of intractable epilepsy 

Answer: The patient is high likely exposed to