Foreign Accent Syndrome: What Does it Consist Of?

Trauma and cerebrovascular disease are some of the causes of this disease.
Foreign Accent Syndrome: What Does it Consist Of?
Diego Pereira

Written and verified by el médico Diego Pereira.

Last update: 12 April, 2021

It’s possible that after certain events or illnesses, the affected person will have difficulty speaking with the accent they have always used. This disorder is known as foreign accent syndrome.

Although this condition has been known for more than a century, the cases reported to date are very scarce. If you want to know a little more about this interesting condition, keep reading!

Main characteristics of foreign accent syndrome

This is a rare disease characterized by difficulty in emitting words according to the pronunciation or intonation with which the affected subject used to speak with. That is, the grammatical structure of the articulated sentences is correct, but the way in which they say them changes.

For people close to the first reported cases, this seemed to be a change in accent, which gave rise to the name of this syndrome. For example, a person with a British accent could suffer a brain event that caused them to speak in a similar way to American English.

According to this scientific review article, foreign accent syndrome is based on two different deficits: segmental and prosodic. The first disorder consists of a change in the pronunciation of the vowels, especially with regard to the time used to articulate the words.

Prosodic problems refer to changes in the articulation between different words, increasing or decreasing the time between syllables and, in turn, introducing or eliminating vowels in sentences.

In most of the reported cases, it is an acquired disorder, so some type of brain injury (which we will mention later) is necessary to cause the symptoms. Some reviews suggest that, due to the scarcity of cases reported in recent decades, it’s a condition with a very low incidence, despite its striking symptoms.

Foreign accent syndrome is due to brain disorders.
Anatomical and functional problems of the central nervous system can cause these symptoms.

Some historical antecedents of foreign accent syndrome

The first record of the condition is from 1907, thanks to the work of the neurologist Pierre Marie (1853-1940). The patient in question had suffered a cerebrovascular disease, causing a right hemiplegia (paralysis on that side of the body).

Over time, the patient began to find it difficult to utter words in her usual accent. She was Parisian, and she began to speak as if she were from another region of France.

Another similar case occurred in 1943 with a Norwegian patient named Astrid. The physician Georg Monrad-Krohn (1884-1964) evaluated this case after the patient suffered a gunshot wound to the brain.

She managed to survive, despite having the same paralysis problem as the case evaluated by Dr. Pierre Marie. Over time, she also had difficulty pronouncing some words, and her accent was quite similar to German. This could cause him several personal problems when the Second World War was in full swing, according to some reviews.

Over time, the term gradually gained popularity, despite the fact that it’s still considered a very strange clinical entity today, and even little known to doctors.

What can cause the disease?

Next, we’re going to mention some of the most frequent causes related to this pathology.

Cerebrovascular disease (CVD)

According to this scientific article, in 2011 there were over 116,000 cases of cerebrovascular traumas in Spain alone, representing one of the main causes of morbidity (and mortality) in the population.

It tends to affect older people more, especially those with cardiovascular risk factors: obesity, diabetes mellitus, metabolic syndrome, and atherosclerosis.

Cerebrovascular diseases are caused by problems in the arterial and venous circulation of the central nervous system, such as strokes. In other situations, such as ischemic accidents, an obstruction occurs caused by solid substances that were generated elsewhere in the body.

The latter can happen, for example, as a consequence of deep vein thrombosis. Here, a blood clot causes an obstruction in an important vein, causing an increase in volume in some of the lower limbs, accompanied by pain and color changes.

These clots can migrate from this area to the lungs and brain, causing CVD. In order to prevent these types of complications, there are some warning signs that you can learn to detect.

Trauma

Foreign accent syndrome can develop after trauma.
Trauma can trigger this and other syndromes.

Several of the reported cases of foreign accent syndrome have to do with head injuries of varying severity. In this case report, we describe the characteristics of a middle-aged woman who suffered a trauma to the right cerebral hemisphere, presenting a vascular injury as a complication.

During the recovery process, the patient began to speak in her native language (Spanish) with a profound change in pronunciation that she couldn’t avoid. When consulting several people, the opinions were diverse, identifying their origin as British, French or German. In short, it was a typical case of this disease.

The trauma, like the other causes mentioned in this article, appears to coincide in terms of the anatomical areas of the main injury. Some of them are the following:

  • The premotor area
  • The basal ganglia, vital structures related to Parkinson’s disease
  • The cerebellum

Multiple sclerosis

This is a chronic, inflammatory and autoimmune disease, characterized by damage to the natural lining of the nerves, called the myelin sheath. This, in the long run, affects the correct transmission of electrical impulses throughout the body, which gives rise to the main symptoms of the disease.

The clinical manifestations are very diverse, a fact that can delay the diagnosis. For example, visual disturbances may occur due to inflammation of the optic nerve. There may also be fatigue, difficulty articulating some words, double vision, seizures, and other abnormal and involuntary movements.

Its relationship with foreign accent syndrome has been little explored due to the scarcity of cases. In 2003 this study was published in which a young patient (38 years old) presented a spontaneous clinical condition of language disorders that, over time, was diagnosed as a consequence of multiple sclerosis.

Diagnosis

The diagnosis is usually made from a clinical point of view, taking into account the personal history of the patient. This syndrome can often be confused with other language disorders, so it may be a poorly diagnosed condition.

Depending on the most likely cause, the doctor may order any of the following studies to complement the clinical diagnosis:

  • Computed tomography
  • Nuclear magnetic resonance

There are several differences between the two studies, especially in terms of cost, image quality, and indications. Also, CT scans emit radiation to work, something that MRI doesn’t.

Treatment

There’s no definitive treatment for this condition. This is logical, considering how little is known about the disease, in addition to the particular characteristics of the conditions that cause it.

However, early speech therapy can provide symptomatic relief in a large number of cases. This treatment aims to carry out specific training to change the pronunciation of some words.

A strange and conspicuous condition

Foreign accent syndrome is a very particular condition that is still not well understood. In case of presenting any symptoms similar to those described in this article, it is advisable to go to a trusted neurologist, who is the specialist in medical diseases of the nervous system.

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