NEW YORK, NY —
While most people would consider the diagnosis of a seizure-producing brain tumor to be bad news, for 18-year-old Chasin Mizrahi, from Woodbury, Long Island, he was actually relieved to learn of this medical condition because for years he was misdiagnosed as having an anxiety disorder and panic attacks.
The brain tumor, called a ganglioglioma, was surgically removed this past May by John Boockvar, MD, neurosurgeon and director of the Brain Tumor Center at Lenox Hill Hospital and David Langer, MD, the hospital's chair of neurosurgery.
When Mr. Mizrahi was 12 years old, he was in a store with his father and had an unexplainable, odd feeling of anxiety/panic. Diagnosed by his pediatrician with having panic attacks, Mr. Mizrahi was treated with psychological therapy and was told for years that he was suffering from an anxiety disorder. The so-called panic attacks occurred about once per month for the following six years.
What was troubling for Mr. Mizrahi is that, in truth, he never felt anxious. In June 2016, before heading off to college at the University of Buffalo, his mother urged a neurologist to get Mr. Mizrahi a magnetic resonance imaging (MRI) scan of the brain to see if there was an underlying neurological condition. An MRI was performed at North Shore University Hospital, a member of Northwell Health, which revealed a ganglioglioma brain tumor. Mr. Mizrahi was referred to Dr. Boockvar for evaluation and management of this newly diagnosed brain tumor.
"A ganglioglioma is an uncommon type of brain tumor, which can occur in the temporal lobe of children and young adults," said Dr. Boockvar. "This particular type of tumor frequently causes seizures. This would explain that when Mr. Mizrahi was thought to have had anxiety attacks, it was actually seizures."
At this point, Dr. Boockvar enlisted the help of Derek Chong, MD, director of epilepsy at Lenox Hill's Comprehensive Epilepsy Center.
"Using video-electroencephalography, we confirmed that the panic attacks, were in fact, seizures," said Dr. Chong. "We also learned that the seizures were coming from the same side of the brain as the tumor. Mr. Mizrahi was prescribed an anti-seizure medication, but while it helped, it did not fully stop the seizures."
Dr. Boockvar and Dr. Chong concurred that Mr. Mizrahi required the surgical removal of the brain tumor to ensure it did not grow. It also had to be removed because of the seizures. To make sure that it was safe to remove the brain tumor, Mr. Mizrahi underwent a neuropsychological evaluation, including tests of language and memory, which included a Wada test performed by Virginia De Sanctis, PhD, the hospital's chief of neuropsychology.
"A Wada test is used to determine which side of the brain controls language and to assess memory function," said Dr. De Sanctis.
"After navigating a catheter from the artery of the leg into the arteries of the neck, an anesthetic medication is infused to put only one side of the brain to sleep, then testing what the other side can do on its own," explained Rafael Ortiz, MD, the hospital's chief of neuro-endovascular surgery and interventional neuroradiology.
In most people, language dominance is usually found on the left side of the brain, but when Mr. Mizrahi's left side was put to sleep, language functioning was not interrupted -- meaning that language functioning had moved to the right side and could function by itself. This meant that the tumor could be safely removed from the left side without disrupting language functioning.
"During the surgery, we recorded the electrical activity directly from the surfaces of the brain, and found the abnormal tissue that caused the seizures," added Dr. Chong. "This helped Dr. Boockvar tailor the surgery to not only remove the tumor, but cure the epilepsy at the same time."
Since Dr. Boockvar and Dr. Langer removed Mr. Mizrahi's tumor, he has been seizure-free. He is looking forward to the summer as a camp counselor in the Adirondack's. "The surgery changed by life," said Mr. Mizrahi. "My advice to other people is to always get a second opinion – that's what saved my life."
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About Lenox Hill Hospital
Lenox Hill Hospital, a member of Northwell Health, is a 652-bed, fully accredited, acute care hospital located on Manhattan's Upper East Side with a national reputation for outstanding patient care and innovative medical and surgical treatments. US News & World Report has ranked the hospital among the nation's top 50 in Cardiology and Heart Surgery and among the top 10 hospitals in the state of New York with a total of 11 "high performing" designations for its clinical performance in Cancer, Diabetes & Endocrinology, Ear, Nose & Throat, Gastroenterology & GI Surgery, Geriatrics, Gynecology, Nephrology, Neurology & Neurosurgery, Orthopedics, Pulmonology and Urology. For more information, go to www.lenoxhillhospital.org