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The Mysterious Phenomenon of Foreign Accent Syndrome

The human brain and its capabilities are realms that we are only just beginning to understand, and much of this domain is still dark and as mysterious as the deepest reaches of space. There are all manner of conditions and phenomena of the brain and mind that we have yet to understand, their mysteries evading us even as we desperately strive to grasp at them. Among these are spooky conditions that affect a persons behavior, mannerisms, or speech, and one is a very real scenario in which people have, for reasons we have yet to understand, suddenly begun to speak in an accent from some faraway land they have never been to.

The mysterious condition known as Foreign Accent Syndrome (FAS) is a medical condition in which patients suddenly and inexplicably develop a foreign accent after some sort of accident, trauma, or sometimes for reasons that are unknown. The accent is almost always from a place the patient has never even been to before, and can range from either being a vague and general accent like “a European accent” or “Russian accent” to being very specific to a particular region within a country, such as an American picking up a Manchester accent from England. Interestingly, the speaker might pick up an accent of a foreign language, yet not attain any fluency with that accent’s native tongue. For instance, an English speaker may pick up a French accent without actually gaining the ability to speak French. The speaker is often well aware that they are speaking differently, yet are unsure why they are using this accent or where it even comes from, and cannot consciously control it. If it all sounds pretty bizarre that’s because it is, and this has been documented for a long time without anyone really gaining any understanding of exactly how or why it happens.

The first documented case of FAS comes from the year 1907, when the French neurologist Pierre Marie studied a Parisian man who developed an Alsatian accent after a stroke. After that, further cases would be reported over the years. Another early case was in 1941, when neurologist Georg Herman Monrad-Krohn studied a Norwegian woman named Astrid, who was hit in the brain with shrapnel during a World War II raid. She soon after developed a German accent, which caused her a lot of problems, as the Germans at the time had been occupying Norway since 1940, and she was often shunned by her own people or refused service in shops because she was mistaken as German by fellow Norwegians. Try as she might, she could never shake this accent, and it haunted her to her grave. At the time there was no agreed-upon name for the condition, and it would not be until 1982 that the neurolinguist Harry Whitaker would coin the phrase “Foreign Accent Syndrome.”

Cases have persisted sporadically all the way up into the present day, and they can cover a wide range of scenarios and be pretty strange. In some cases, there is some very obvious physical trauma or injury involved, such as an accident, head injury, tumor, or stroke. One such case typical of this kind of FAS comes to us from 2005, when a woman named Leanne Rowe, of Tasmania, Australia, was involved in a serious car accident, suffering a broken back and jaw. When she woke up in Melbourne’s Austin Hospital, she had slurred speech due to her injuries, but after she healed she was astonished to find that she now spoke with a noticeable French accent, which was weird because she had never been to France or any French speaking country and had no particular interest in the language or culture. She has never been able to drop the accent, and Ms. Rowe says she has developed anxiety and depression since the accident and her daughter speaks for her in public. She has lamented, “It makes me so angry because I am Australian. I am not French, though I do not have anything against the French people.”

It might be easy to think that the syndrome and symptoms must be caused by some sort of serious injury or trauma, but this is not always the case, with some cases having no apparent cause at all. This is called psychogenic foreign-accent syndrome, when there is no trace of any brain damage or physical reason why the patient should suddenly start speaking in a foreign accent. In one such case, in 2011 an American woman in the state of Oregon by the name of Karen Butler went in for routine dental surgery to remove some wisdom teeth, and when the numbness of the anesthetic wore off she found that she now spoke with a British accent. Although she has been diagnosed with FAS, doctors have been unable to find any brain damage or possible cause for her condition, making it very mysterious indeed why she should have any speech impediment at all, let alone a foreign accent. The best they can come up with is that Butler suffered some sort of minor stroke during the surgery, but there is no physical evidence of this and no known reason for why she should suddenly start speaking with a British accent. In the meantime, the accent has never gone away. Another case happened in 2011 as well, this time with a woman named Julie Matthias, 49, of Kent, England, who developed an accent regularly mistaken for being South African, French or Italian, after having a serious migraine headache that left no apparent damage behind.

In some cases, there are no physical brain problems or identifiable organic brain injury, nor even any health issue at all, but the patient displays deep mental problems that may lie at the root of it. One such case occurred in 2016 and was reported in Case Reports of Psychiatry. It involves a 34-Year-Old African American female diagnosed with paranoid schizophrenia, and it is an odd case to say the least. The patient was admitted to the psychiatry emergency room by ambulance for evaluation of aggression after an altercation in which she had attacked her landlady and accused her of using Voodoo magic to curse her to make her hair fall out. After this, she had developed a distinct and unmistakeable British accent, and no one seems to be sure why. The strange report reads in part:

There was no symptom suggestive of mania, seizure disorder, head trauma, loss of consciousness, cerebrovascular accident, Parkinson’s disease, anxiety, or other organic brain disorder. The patient denied use of nicotine, alcohol, and other psychoactive substances currently or in the past. The patient had her first inpatient psychiatry admission for acute exacerbation of paranoid schizophrenia and FAS ten months earlier. She was then treated with risperidone tablets with improvement including change in accent on discharge, when she was less psychotic. The patient had a family history of sickle cell disease (brother had sickle cell disease) and schizophrenia (brother, mother, and uncle had schizophrenia). Birth and developmental history were unremarkable. There were no reported behavioral or learning disabilities, and the patient denied being a victim of emotional, physical, or sexual abuse. She had some college education and worked as a nurse aide up till five months prior to presentation to the hospital. Mental status examination showed a middle-aged, well-groomed, dark-haired woman with poor eye contact and in no apparent distress. The patient was tangential and preoccupied with “voodoo” and was deeply paranoid of her neighbors and her mother’s landlady. Auditory hallucinations were not elicited, and she denied suicidal ideation at the time of evaluation. The patient continued to endorse homicidal ideation towards her mother’s landlady. She was awake, alert, orientated in time, place, and person, and attentive and had good concentration but had poor impulse control. Her insight and judgment were impaired. Immediate recall and short- and long-term memory were intact.

 

The physical examination of the patient showed no significant pathological findings. Laboratory investigations were unremarkable. Electroencephalogram showed no seizure activity. Structural magnetic resonance imaging (MRI) and MR angiography of the head were both unremarkable. The patient presented with a British-like accent, despite never having lived in Britain, and was therefore investigated by a speech therapist. There was no phonetic problem or grammatical errors, but there was a problem with prosody, including prominence of the pitch of the words and syllables. The patient’s pitch range was narrow, as she sparingly expressed any emotions during speech. Her speech was monotonous, hesitant, and of low volume. She substituted “th” for “f” and “w” for “wh” as well as “t” for “d” and “ai” for “ei.” The patient continued to have psychotic symptoms and her foreign accent remained unchanged. She refused augmentation with any other antipsychotic medication because of paranoia. In the course of treatment, the patient continued to endorse homicidal ideation, paranoid ideation towards her mother’s landlady, and still spoke in a British accent. In view of unremitting psychotic symptoms, she was transferred to a long-term psychiatric inpatient facility.

The wide variety of cases of FAS just add to the mystery of the condition, further exacerbated by the fact that no one is really sure what mechanisms cause it or why it should manifest as a foreign accent. Researchers including speech-language pathologists, neurolinguists, neurologists, neuropsychologists, and psychologists can’t agree on what is happening here or even how to diagnose it, and there are many questions for which the answers are completely unknown. Is it caused by brain damage, and if so why does the same thing happen with people who have sustained damage to completely different parts of the brain and why does FAS affect even people with no discernible damage at all? If it is brain damage, then why should it just cause a change of accent? Is it just a speech impediment? FAS is similar to a condition called apraxia of speech (AoS), which is a motor speech disorder, but why should it in these cases appear as a change to a foreign accent rather than a more serious speech disability? Also, AOS often occurs after a stroke or brain injury, so this still doesn’t explain cases of psychogenic FAS. Some researchers doubt that what is heard in the speech is even a foreign accent at all, but rather the speaker trying to subconsciously cover up a speech impediment, or just a form of pareidolia, in which someone sees or hears what they want, on the part of the listener. Nick Miller, Professor of Motor Speech Disorders at Newcastle University has explained of this:

The notion that sufferers speak in a foreign language is something that is in the ear of the listener, rather than the mouth of the speaker. It is simply that the rhythm and pronunciation of speech has changed.

There are no clear answers to any of these questions, and it is so rare, with only 62 recorded cases between 1941 and 2009, that it seems unlikely we will understand it all anytime soon. In the meantime, there is no real treatment for the sufferers, who often have to deal with a loss of identity and negative treatment from those around them, and they are left speaking with a voice that is not really their own. What is happening to these people and why does it affect them in this very specific way, making them speak like a foreigner in their own land? Perhaps one day we will have a better idea, but for now Foreign Accent Syndrome remains one more enigmatic mysteries swirling about the human mind.