Foreign Accent Syndrome: Imagine picking thick German or fancy French accent after a brain injury. Anyone interested?


Casually speaking, when an accident of brain injury is reported in hospital what consequences can a doctor list down at once? Stroke, hemorrhage, paralysis or coma are the most common occurrences. An extremely rare and eyebrow-raising encounter is to witness a patient returning to his consciousness and speaking with mild or extreme change in accent. The inquisitive minds dwell over various possibilities but the accurate diagnosis is Foreign Accent Syndrome (FAS).

In 2011, National Public Radio Story documented a case report of a middle-aged woman who underwent dental surgery. This woman named Karen Butler was born and bred in America thus had a strong American accent. She reported no travelling history to Europe. During the surgery, Karen was put under anesthesia while dentist removed several teeth. As soon as she woke up she noticed how funny her speech had become. After dental surgery, usually speech becomes slightly disordered but as the swelling heals speech becomes normal. As time passed the swelling in Karen’s mouth healed. Surprisingly, the accent remained. Although she was American by birth her accent after surgery had become a mixture of Irish, British and some other European accents. Karen consulted Dr.  Ted Lowenkopf, neurologist and director of Providence Stroke Center in Portland. She was diagnosed with Foreign Accent Syndrome by Dr. Lowenkopf.

As bizarre the name sounds it is actually what it describes. In Foreign Accent Syndrome (FAS), an individual picks up new accent. Instead of continuing to speak in his native accent there is noticeable change in the accent. The order and delivery of words is absolutely normal giving correct meaning to the speech. However, timing, intonation and tongue placement is altered due to which a foreign accent is produced. Consonant substitution, errors in voicing, deletion and distortion of consonants and vowels, excessive stress in multi-syllabic words and prolongations and substitutions of vowels such as speaking “yah” instead of “yeah” are commonly observed. The new accent can be anyone across the globe, from Chinese and Korean to German, French and different versions of English it can be anyone. The cases reported show change in accent from Japanese to Korean, British English to French, American English to British English and Spanish to Hungarian. Usually, it is caused by trauma to brain. However in some cases the cause is unidentified.

Foreign Accent Syndrome (FAS) has only around 100 cases reported. Historical background of FAS reflects its first case in 1940s. In World War II, a Norwegian woman was hit by a shrapnel. Unbelievably, due to brain damage she developed German accent. The troops could not afford a woman with thick German accent due to the danger hovering over them therefore they expelled her from their community.

Since FAS is caused by damage to speech area of brain called Broca’s area therefore eliminating the cause is important rather than expelling or disowning people. Anti-clotting medications for stroke, anti-seizure medications for brain injuries, diuretics to control pressure in brain, disease-modifying therapy to control the progress of multiple sclerosis and surgical procedures for vascular and non-vascular emergencies can possibly reverse Foreign Accent Syndrome.

Foreign Accent Syndrome is completely harmless unless the damage to brain is severe enough to affect other parts as well.


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Dr. Bilal Zafar is a talented healthcare professional who has immaculately balanced his professional and personal life and, in 2017, successfully completed his Bachelors of Medicine and Surgery from Dow University of Health Sciences. He practiced his skills and earned exclusive expertise in Sindh Government Lyari General Hospital where he served as a House Officer (HO). His remarkable outlook has made it possible for him to become a reputable name in the medical writing industry and he is now CEO of Astro Medical Writers. He has earned a partnership with Medizzy, an emerging UK based app for medical students and health professionals. He also has vast working experience with various medical platforms and organizations including the American Physician Institute (API) for Advanced and professional studies. Dr. Bilal Zafar is currently serving as the Asian President of Oli Health magazine, a Turkey-based Health Magazine. Also, he is an ambassador of Banja Luka International Medical Congress (BLIMC) 2019, the 25th Scientific Congress of Hellenic Medical Students and the 13th International Forum for Medical Students and Junior Doctors, from Pakistan. He also has a deep interest in Psychiatry and is now pursuing this field further. He has several published articles on the subject of mental illness with ongoing research in the same domain. As well as being a doctor and entrepreneur, Dr. Bilal has a knack for playing the guitar and might even qualify as a professional guitarist in the near future.


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