Foreign Accent Syndrome

(Editor’s Note: Do you know what Foreign Accent Syndrome is? Writer, longtime BEST blog contributor, and stroke survivor, Isaac Peterson, does a deep dive into this unusual and rare condition. KT) 

By now you know the common difficulties caused by traumatic brain injury (TBI), especially if you yourself have a TBI. I don’t need to list those again for the 3,487th time.

But here’s one I’ll bet you never heard of: foreign accent syndrome. I hadn’t heard of it until just the other day. 

Foreign accent syndrome (FAS) is pretty much what the name says it is: every once in a great while, a TBI survivor will, just out of the blue, start speaking with a foreign accent. Symptoms can last for months, years, or may be permanent.

It’s extremely rare—there are only about 100 documented cases in the U.S. in the last 100 years or so.  It appears that FAS is related to conditions that affect the Broca’s area of the brain. The Broca’s area is on the left side of the brain and is linked to speech.

TBI survivors with FAS still speak the same language as before, but with a new accent. American-English speech may come across sounding like British-English, for one example. This isn’t a deliberate thing survivors do; it’s a result of how the language centers are affected. Patients may also have trouble putting sentences together, or may stress the wrong words or syllables.

It’s most common after a head injury, stroke, brain tumor, or some other type of injury to the brain.

Can you imagine foreign accent syndrome on top of other TBI-related challenges like re-learning how to walk, talk, read, make toast, and more?

My guess is it could increase the feelings of loneliness and isolation many survivors feel, especially with former acquaintances who already are uncomfortable with TBI-related changes that can make a survivor seem like an entirely different person than before. 

FAS is kind of similar to aphasia, the lack of ability to speak or understand speech—it can go away after a few months, years, or may be permanent. It has been known to happen with other languages and cultures all over the world

There are two different types of foreign-accent syndrome that have been reported—neurogenic and psychogenic.

Neurogenic FAS is more common, and is the type associated with traumatic brain injury—blunt force trauma, strokes, and aneurysms, all the usual causes of TBI, especially to the brain’s left hemisphere.

Psychogenic FAS happens when a brain injury happens where there’s no identifiable injury. It seems more closely associated with disorders like schizophrenia, bipolar disorder, multiple sclerosis, or conversion disorder.

Although most people have probably never heard of FAS, it’s recognized as a legitimate neurological condition. Treatment for FAS depends on the cause.

If the cause can’t be identified, possible treatments may be speech therapy and counseling.

When a cause can be identified possible treatments may include: 

For stroke: anti-clotting medication, or surgically removing the clot.

Brain injuries: anti-seizure meds may be prescribed for major injuries, and/or any of the usual TBI treatments.

Aneurysms: surgically clipping blood vessels to stop the flow of blood to the affected area.

Multiple sclerosis: disease-modifying therapies.

If there are any sudden changes to speech, definitely get medical attention as soon as possible to determine whether the cause is serious or requires treatment.

But no matter what, see a doctor.

Isaac Peterson grew up on an Air Force base near  Cheyenne, Wyoming. After graduating from the University of Wyoming, he embarked on a career as an award-winning investigative journalist and as a semi-professional musician in the Twin Cities, the place he called home on and off for 35 years. He also doesn’t mind it at all if someone offers to pick up his restaurant tab. Peterson also welcomes reader comments. Email him at isaac3rd@gmail.com.