The Rare and Strange “Foreign Accent Syndrome” – What Is It?

You may have probably heard the news of an Australian woman who woke up after undergoing surgery, only to find herself suddenly speaking with an Irish accent. In a separate but similar case, a Texan woman went to the hospital to have surgery. After surgery, she woke up and found herself suddenly picking up a British accent.

It looks like these women are acting or making this up, but they’re afflicted with a real and strange medical condition called the Foreign Accent Syndrome (FAS). It happens when a native speaker is perceived to speak with a “foreign” accent. It is a rare speech disorder. This medical mystery has left doctors, scientists, and analysts stumped since this curious condition was first identified.

What causes Foreign Accent Syndrome?

Foreign accent syndrome is usually caused by damage to the part of the brain that controls and governs various linguistic functions. Damage to that region of the brain could result in altered pitch and/or pronunciation of syllables, causing speech patterns to be distorted in a non-specified manner. The damage may be due to:

• Stroke (the most common cause)
• Aneurysm
• Traumatic brain injury (especially from a sharp blow to the head)
• Brain hemorrhage
• Brain tumor
• Multiple sclerosis

Common changes associated with Foreign Accent Syndrome

• Fairly predictable vowel and consonantal errors;
• Unusual prosody, which includes identical-sounding and excess stress (especially in words with many syllables)
• Consonant distortion, omission, or substitution;
• Voicing errors (for example, “bike” for “pike”);
• Difficulty producing consonant clusters;
• Vowel distortions, prolongations (for example, “wwwww… well”) and substitutions (for example, “yeah” pronounced as “yah”).
• Fillers like “uh,” “um,” “ah,” etc.

Apart from those changes, the patient’s mental health is otherwise good and stable, and no underlying mental health condition is causing these accent changes.

Risk factors

Factors and speech disorders that may raise the risk of Foreign Accent Syndrome:

• High risk for stroke
• Aphasia – the inability to comprehend and express language
• Apraxia of speech – problems in making intelligible sounds, syllables, and words
• Dysarthria – slurred or slow speech that can be difficult to understand
• Agrammatism – a common feature on people suffering from Broca’s aphasia (non-fluent aphasia); problems with using basic grammar and syntax, word order, or sentence structure.

A person with Foreign Accent Syndrome may be able to speak and have other people understand them. The accent may also be spoken within the same language, such as American to British, British to American, American to Australian, Australian to American, American to Irish, etc. 

In a rare case, a British woman named Sarah Colwill had a stroke and woke up losing her strong Devon accent overnight. Instead, she suddenly spoke with a Chinese accent, despite never having been to China.

The symptoms of Foreign Accent Syndrome may last for many months or years. Or they may be permanent. In Ms. Colwill’s case, it took her eight years before she got her native Devon accent back, when she had to accept that her acquired Far Eastern accent would be there to stay.

Diagnosis

Your doctor will ask you about your symptoms and health history. They may also do an examination on the muscles you use to speak. In addition, they may do a mental health exam – they are likely to see images of your brain through an MRI scan or CT scan, both of which create detailed images of features inside your brain.

Since Foreign Accent Syndrome is so rare, it takes a multi-disciplinary team of different specialists to assess your condition and diagnose it. These specialists include:

• Speech-language pathologist
• Neurolinguist
• Neuropsychologist
• Neurologist 
• Psychologist

Treatment options

Treatment for Foreign Accent Syndrome depends on the underlying cause.

If there’s no underlying cause, possible treatments may include:

• Speech therapy – to learn how to recreate your old accent through vocal exercises that are targeted at pronouncing sounds deliberately in your normal accent;
• Counseling, therapy, or support groups – to help you cope with certain issues (such as people believing you’re faking a new accent or your identity being “lost”) that you’re currently dealing with as a result of this syndrome.

But if there is an underlying cause behind this syndrome, the following treatments are usually medical (mostly surgical):

• Stroke – anticlotting medications or surgical clot removal;
• Brain injuries – anti-seizure medications, diuretics to decrease pressure in the brain, or surgery to repair any major damages.
• Aneurysm – surgical clipping of blood vessels to prevent blood flow to the aneurysm;
• Multiple sclerosis – therapy to slow down the progress of symptoms.

Prevention

So far, there is no known guideline to prevent Foreign Accent Syndrome. But since the most common cause of this syndrome is stroke, people who are at risk for it should take steps to lower the risk.

Number of cases

Foreign Accent Syndrome is an exceedingly rare condition; so far, there have been only over 100 cases in the world in the past.

It’s interesting to note that out of these cases, this syndrome affects more commonly in females than in males. Whether gender has something to do with this condition, we will never know for certain.

Here are some notable cases of this strange and mysterious syndrome:

• A young woman, named only as “Astrid L”, suffered a head injury after she was hit by a shrapnel during World War II. After recovering from the injury, she suddenly spoke with a German accent and was ostracized by her fellow Norwegians.
• An American woman, Karen Butler, went for a dental surgery. After she woke up, Butler’s accent suddenly became a hodgepodge of British, Irish, and perhaps a mix of European accents, despite never having gone to Europe.
• Another American woman, Summer Diaz, was hit by a car while she was crossing the street. After being placed in an induced coma for two weeks, Diaz woke up suddenly speaking with a Kiwi accent, despite never having been to New Zealand.